Left ventricular pseudoaneurysm(LVPA) is a rare type of abnormal ventricular wall bulge formed by injury to the inner wall of the left ventricle. The exterior wall only consists of epicardium or/and pericardium. In a systematic literature review, myocardial infarction(55%), surgery(33%), and trauma(7%) are the top three associations. Being affected by the high pressure of the left ventricle, LVPA has the risk of enlargement and rupture, which can lead to sudden death. The treatment of LVPA consists of three main modalities: medication, surgery, and transcatheter closure. In the past, surgery was the preferred treatment for LVPA, but the surgery was highly invasive, traumatic, and associated with increased risks. In recent years, transcatheter closure has been developed and applied clinically with good results. The benefits of minimal invasiveness and quick recovery have emerged as a popular treatment for LVPA. Currently, the etiology, formation, and treatment of LVPA are not clearly defined. Large-sample studies and authoritative guidelines to guide the treatment are scarce. The timing, imaging modality, and access routes to LVPA for both surgery and transcatheter closure are still controversial. In this article, we review the relevant literatures and draw the following conclusions as: (1) Diagnostic workup is essential for anatomical characterization of LVPA, which is mandatory to guide the decision on surgical methods.(2) For a subset of patients with LVPA and a well-defined fibrotic neck, and deemed at high surgical risk, transcatheter closure of the cavity has been described with encouraging results.

Objective:To investigate the impact of correcting rotational subluxation through circumferential fusion and transforaminal lumbar interbody fusion (TLIF) on postoperative coronal plane imbalance in degenerative scoliosis.Methods:A retrospective analysis was conducted on the data of 108 patients with type A degenerative scoliosis in the Nanjing classification who underwent primary multi-segment posterior column osteotomy (PCO) with deformity correction and internal fixation at Nanjing Gulou Hospital from June 2017 to June 2021. Patients were divided into two groups based on the presence of preoperative rotational subluxation: the rotational subluxation group and the non-rotational subluxation group. The rotational subluxation group consisted of 60 patients, with 8 males and 52 females, aged 63.7±5.5 years (range, 56-75 years). The non-rotational subluxation group included 48 patients, with 5 males and 43 females, aged 64.4±5.2 years (range, 53-72 years). Within the rotational subluxation group, depending on whether TLIF was performed on the rotational subluxation segment, they were further categorized into the TLIF group and the PCO group. The TLIF group comprised 28 patients, while the PCO group had 32 patients. Full-spine anteroposterior and lateral X-rays were taken preoperatively, postoperatively, and at the last follow-up to measure coronal balance types and radiographic parameters. The differences in the lumbar Cobb angle, coronal balance distance (CBD), and the Cobb angle of the lumbosacral curve (Cobb-Fra angle) were compared between the rotational subluxation group and the non-rotational subluxation group, as well as between the TLIF group and the PCO group.Results:The average surgery duration ranged from 200 to 310 min, with a mean of 235±47 min. The intraoperative blood loss ranged from 700 to 2,400 ml, with an average of 950±355 ml. The number of fused segments in the rotational subluxation group was 7.6±2.1, ranging from 5 to 11 segments, while in the non-rotational subluxation group, it was 7.4±2.0, ranging from 5 to 10 segments. Postoperatively, 13%(8/60) of patients in the rotational subluxation group developed type C coronal imbalance, significantly higher than the 2%(1/48) in the non-rotational subluxation group. The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the rotational subluxation group were 20.60°±10.73° and 20.33°±10.92°, 22.53±16.45 mm and 18.53±17.31 mm, 13.14°±4.40° and 11.23°±4.92°, respectively, which were higher than those in the non-rotational subluxation group (13.92°±7.02° and 12.92°±6.64°, 18.62±17.44 mm and 8.83±8.95 mm, 11.91°±3.03° and 9.52°±3.30°), with statistical significance ( P<0.05).. Among patients in the rotational subluxation group, the probability of new-onset coronal imbalance postoperatively was 4%(1/28) in the TLIF group, which was lower than the 22%(7/32) in the PCO group, with a statistically significant difference (χ 2=4.330, P=0.037). The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the PCO group were 25.63°±11.00° and 25.13°±11.04°, 27.37±18.95 mm and 25.25±18.67 mm, 15.50°±3.62° and 14.08°±4.77°, respectively, which were significantly higher than those in the TLIF group (14.86°±6.96° and 14.86°±5.37°, 17.08±10.94 mm and 10.86±7.86 mm, 10.14°±3.37° and 8.46°±2.66°), with statistical significance ( P<0.05). Conclusion:For patients with Type A degenerative scoliosis combined with rotational subluxation according to the Nanjing classification, performing a 360-degree circumferential release and interbody fusion at the segment with rotatory subluxation can reduce the risk of developing new postoperative coronal imbalances.

An 8-year-old male patient with chronic granulomatous disease received amphotericin B liposome (unknown dose) in addition to anti-infection treatments with meropenem, compound sulfamethoxazole, and voriconazole due to recurrence of secondary pulmonary infection. After 3 days, the patient developed tachycardia, edema, and worsening dyspnea. Echocardiography revealed severe right heart enlarge- ment and pulmonary hypertension. Cardiotonic, diuretic, and pulmonary antihypertensive therapies were given. After over half a month, his pulmonary infection was improved, pulmonary arterial pressure decreased, but the right heart enlargement persisted. Suspending treatment about half a month later, amphotericin B liposome was reinitiated at a gradually increased dose from 2 mg once daily, in combination with piperacillin sodium and tazobactam sodium and compound sulfamethoxazole due to aggravated cyanosis and cough. After the administration of amphotericin B liposome (50 mg once daily) on day 5, the patient experienced wheezing and facial edema. Laboratory tests showed B-type natriuretic peptide (BNP) 4 679 ng/L; echocardiography demonstrated right heart enlargement and pulmonary hypertension. Suspecting that the cardiac dilatation and heart failure were associated with amphotericin B liposome, the drug was discontinued. The anti-infection regimen was switched to biapenem, linezolid and voriconazole, along with continued cardiotonic and diuretic managements. The patient′s symptoms were improved after 10 days, the treatment regimen was changed to compound sulfamethoxazole and voriconazole. However, after 3 days, the patient′s abdominal distension and dyspnea worsened. Endotracheal intubation and mechanical ventilation were initiated along with cardiotonic and diuretic therapy; anti-infection therapy with cefoperazone sodium and sulbactam sodium combined with voriconazole was given based on bronchoalveolar lavage fluid and sputum culture results. One month later, the patient′s condition was improved, showing no right ventricular dilation and reduced pulmonary arterial pressure on echocardiography and BNP 800 ng/L.

Objective:To investigate the impact of correcting rotational subluxation through circumferential fusion and transforaminal lumbar interbody fusion (TLIF) on postoperative coronal plane imbalance in degenerative scoliosis.Methods:A retrospective analysis was conducted on the data of 108 patients with type A degenerative scoliosis in the Nanjing classification who underwent primary multi-segment posterior column osteotomy (PCO) with deformity correction and internal fixation at Nanjing Gulou Hospital from June 2017 to June 2021. Patients were divided into two groups based on the presence of preoperative rotational subluxation: the rotational subluxation group and the non-rotational subluxation group. The rotational subluxation group consisted of 60 patients, with 8 males and 52 females, aged 63.7±5.5 years (range, 56-75 years). The non-rotational subluxation group included 48 patients, with 5 males and 43 females, aged 64.4±5.2 years (range, 53-72 years). Within the rotational subluxation group, depending on whether TLIF was performed on the rotational subluxation segment, they were further categorized into the TLIF group and the PCO group. The TLIF group comprised 28 patients, while the PCO group had 32 patients. Full-spine anteroposterior and lateral X-rays were taken preoperatively, postoperatively, and at the last follow-up to measure coronal balance types and radiographic parameters. The differences in the lumbar Cobb angle, coronal balance distance (CBD), and the Cobb angle of the lumbosacral curve (Cobb-Fra angle) were compared between the rotational subluxation group and the non-rotational subluxation group, as well as between the TLIF group and the PCO group.Results:The average surgery duration ranged from 200 to 310 min, with a mean of 235±47 min. The intraoperative blood loss ranged from 700 to 2,400 ml, with an average of 950±355 ml. The number of fused segments in the rotational subluxation group was 7.6±2.1, ranging from 5 to 11 segments, while in the non-rotational subluxation group, it was 7.4±2.0, ranging from 5 to 10 segments. Postoperatively, 13%(8/60) of patients in the rotational subluxation group developed type C coronal imbalance, significantly higher than the 2%(1/48) in the non-rotational subluxation group. The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the rotational subluxation group were 20.60°±10.73° and 20.33°±10.92°, 22.53±16.45 mm and 18.53±17.31 mm, 13.14°±4.40° and 11.23°±4.92°, respectively, which were higher than those in the non-rotational subluxation group (13.92°±7.02° and 12.92°±6.64°, 18.62±17.44 mm and 8.83±8.95 mm, 11.91°±3.03° and 9.52°±3.30°), with statistical significance ( P<0.05).. Among patients in the rotational subluxation group, the probability of new-onset coronal imbalance postoperatively was 4%(1/28) in the TLIF group, which was lower than the 22%(7/32) in the PCO group, with a statistically significant difference (χ 2=4.330, P=0.037). The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the PCO group were 25.63°±11.00° and 25.13°±11.04°, 27.37±18.95 mm and 25.25±18.67 mm, 15.50°±3.62° and 14.08°±4.77°, respectively, which were significantly higher than those in the TLIF group (14.86°±6.96° and 14.86°±5.37°, 17.08±10.94 mm and 10.86±7.86 mm, 10.14°±3.37° and 8.46°±2.66°), with statistical significance ( P<0.05). Conclusion:For patients with Type A degenerative scoliosis combined with rotational subluxation according to the Nanjing classification, performing a 360-degree circumferential release and interbody fusion at the segment with rotatory subluxation can reduce the risk of developing new postoperative coronal imbalances.

An 8-year-old male patient with chronic granulomatous disease received amphotericin B liposome (unknown dose) in addition to anti-infection treatments with meropenem, compound sulfamethoxazole, and voriconazole due to recurrence of secondary pulmonary infection. After 3 days, the patient developed tachycardia, edema, and worsening dyspnea. Echocardiography revealed severe right heart enlarge- ment and pulmonary hypertension. Cardiotonic, diuretic, and pulmonary antihypertensive therapies were given. After over half a month, his pulmonary infection was improved, pulmonary arterial pressure decreased, but the right heart enlargement persisted. Suspending treatment about half a month later, amphotericin B liposome was reinitiated at a gradually increased dose from 2 mg once daily, in combination with piperacillin sodium and tazobactam sodium and compound sulfamethoxazole due to aggravated cyanosis and cough. After the administration of amphotericin B liposome (50 mg once daily) on day 5, the patient experienced wheezing and facial edema. Laboratory tests showed B-type natriuretic peptide (BNP) 4 679 ng/L; echocardiography demonstrated right heart enlargement and pulmonary hypertension. Suspecting that the cardiac dilatation and heart failure were associated with amphotericin B liposome, the drug was discontinued. The anti-infection regimen was switched to biapenem, linezolid and voriconazole, along with continued cardiotonic and diuretic managements. The patient′s symptoms were improved after 10 days, the treatment regimen was changed to compound sulfamethoxazole and voriconazole. However, after 3 days, the patient′s abdominal distension and dyspnea worsened. Endotracheal intubation and mechanical ventilation were initiated along with cardiotonic and diuretic therapy; anti-infection therapy with cefoperazone sodium and sulbactam sodium combined with voriconazole was given based on bronchoalveolar lavage fluid and sputum culture results. One month later, the patient′s condition was improved, showing no right ventricular dilation and reduced pulmonary arterial pressure on echocardiography and BNP 800 ng/L.

Left ventricular pseudoaneurysm(LVPA) is a rare type of abnormal ventricular wall bulge formed by injury to the inner wall of the left ventricle. The exterior wall only consists of epicardium or/and pericardium. In a systematic literature review, myocardial infarction(55%), surgery(33%), and trauma(7%) are the top three associations. Being affected by the high pressure of the left ventricle, LVPA has the risk of enlargement and rupture, which can lead to sudden death. The treatment of LVPA consists of three main modalities: medication, surgery, and transcatheter closure. In the past, surgery was the preferred treatment for LVPA, but the surgery was highly invasive, traumatic, and associated with increased risks. In recent years, transcatheter closure has been developed and applied clinically with good results. The benefits of minimal invasiveness and quick recovery have emerged as a popular treatment for LVPA. Currently, the etiology, formation, and treatment of LVPA are not clearly defined. Large-sample studies and authoritative guidelines to guide the treatment are scarce. The timing, imaging modality, and access routes to LVPA for both surgery and transcatheter closure are still controversial. In this article, we review the relevant literatures and draw the following conclusions as: (1) Diagnostic workup is essential for anatomical characterization of LVPA, which is mandatory to guide the decision on surgical methods.(2) For a subset of patients with LVPA and a well-defined fibrotic neck, and deemed at high surgical risk, transcatheter closure of the cavity has been described with encouraging results.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective To study the effect of fine particulate matter(particulate matter 2.5,PM2.5)exposure on hepatic lymphangiogenesis in C57BL/6J mice and metabolic-associated fatty liver disease(MAFLD)model mice,and to provide a novel target for prevention and treatment of PM2.5-induced liver injury.Methods Forty male C57BL/6J mice were randomly divided into a control group,PM2.5 group,MAFLD group,and PM2.5-MAFLD group.Mice in the MAFLD and PM2.5-MAFLD groups were fed high-fat diet for 12 weeks,and mice in the other groups were fed normal chow diet.From weeks 13 to 16,mice in the PM2.5 and PM2.5-MAFLD groups were exposed to PM2.5 by tracheal instillation(twice per week),and mice in the other groups were instilled with saline at the same time.All animals were euthanized 24 h after the last PM2.5 instillation.Serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were measured,and the expression of LYVE1 in liver tissues was visualized using immunofluorescence staining.Hepatic oxidative stress markers levels(4-HNE and GSH/GSSG)were measured.The protein expression levels of lymphangiogenesis markers(PROX1 and LYVE1),lymphangiogenesis regulatory protein VEGF-C,and the lymphatic junctional function marker VE-cadherin in liver tissue were determined using Western Blot.Results PM2.5 exposure significantly increased the levels of serum AST and ALT,markedly decreased the protein expression of PROX1 and LYVE1,increased the protein expression of VEGF-C and VE-cadherin in the liver,increased the level of 4-HNE,and decreased the T-GSH/GSSG ratio in livers of mice in the MAFLD group(P＜0.05).However,PM2.5 exposure did not affect the levels of serum AST and ALT,protein expression of PROX1,LYVE1,or VEGF-C;level of 4-HNE;or T-GSH/GSSG ratio in the livers of the C57BL/6J mice(P＞0.05).Conclusions PM2.5 exposure obviously aggravated hepatic oxidative injury and reduced hepatic lymphangiogenesis by reducing the VEGF-C concentration in the livers of MAFLD model mice.

Objective To investigate the effects of acute sleep deprivation on the behavior and synaptic protein expression of rats.Methods Seventy healthy male Wistar rats were randomly divided into seven groups,a Control group and sleep deprivation groups(24,48,72,96,120 and 144 hours).The sleep deprivation rat model was established by the modified multiplatform water environment sleep deprivation method.Spatial learning and memory were assessed by the Morris water maze.Anxiety was assessed by the open field test.The morphology and quantity of hippocampal neurons were observed by Nissl staining.Western blot and Real-time PCR were used to determine the expression of synaptophysin(SYN),post-synaptic density protein-95(PSD-95),and brain-derived neurotrophic factor(BDNF)in rats.Results Compared with the Control group,the numbers of standing and modification were significantly increased by prolongation of the sleep deprivation time(P＜0.05).The escape latency and path length were significantly increased in 120 and 144 h groups(P＜0.05),whereas the number of platform crossings and the percentage of the target quadrant time were significantly decreased(P＜0.01)and negatively correlated to the sleep deprivation time.The expression levels of BDNF,SYN,and PSD-95 were significantly decreased with the prolongation of sleep deprivation time(P＜0.01).Conclusions With the increase in sleep deprivation time,cognitive dysfunction and anxiety gradually deteriorated,which may be related to decreases in the expression of synaptic biomarkers.

Objective To investigate the effects of combined exposure to PM2.5 and a high-salt diet on hepatic inflammation and lymphangiogenesis in mice.Methods Thirty-two C57BL/6J mice were assigned randomly to control,PM2.5,high-salt(HSD),and PM2.5+HSD groups.Mice in the HSD and PM2.5+HSD groups were fed an 8%high-salt diet for 8 weeks,while mice in the other groups were fed a control diet containing 0.4%salt.Mice in the PM2.5 and PM2.5+HSD groups were treated with PM2.5 by tracheal instillation(twice per week),and mice in the other groups were instilled with equal volumes of saline(twice per week).All mice were sacrificed after the last PM2.5 exposure.Tumor necrosis factor-α(TNF-α)and interleukin(IL)-6 levels in the liver tissues of the mice were determined and lymphatic vessel endothelial hyaluronan receptor-1(LYVE1)expression in the liver tissues was visualized by immunofluorescence staining.Protein expression levels of the lymphangiogenesis markers PROX1 and LYVE1,and the lymphangiogenesis regulatory proteins vascular endothelial growth factor(VEGF)receptor(VEGFR)3 and VEGF-C in liver tissue were measured by Western blot.Results TNF-α and IL-6 levels and protein expression levels of PROX1,LYVE1,VEGFR-3,and VEGF-C in liver tissues were increased in the HSD group compared with the control group(P＜0.05),and in the PM2.5+HSD group compared with the HSD group(P＜0.05).Moreover,there were significant interaction effects between PM2.5 and a high-salt diet on these above indicators.Conclusions Combined exposure to PM2.5 and a high-salt diet aggravated hepatic inflammation and may increase hepatic lymphangiogenesis by upregulating VEGFR-3 and VEGF-C in liver of mice.