Objective:To investigate the clinical significance of prenatal screening and genetic analysis in the diagnosis of fetal aberrant right subclavian artery(ARSA).Methods:The ultrasonographic features of ARSA fetu-ses detected by prenatal ultrasound at the University of Hong Kong-Shenzhen Hospital from October 2017 to March 2022 were retrospectively analyzed.The fetuses were divided into isolated ARSA group and complicated ARSA group.Their genetic analysis results and pregnancy outcome were analyzed.Results:Among 30,260 preg-nant women,185 fetuses were diagnosed with ARSA by prenatal ultrasound screening,with an incidence of 0.6％;5 fetuses(2.6％)were diagnosed by ultrasound in the first trimester,and the remaining were diagnosed by fetal grade Ⅲ structural ultrasound examination at 20～24 weeks' gestation.Among them,158 fetuses(85.4％)had isolated ARSA,and 27(14.6％)had complicated ARSA.Among fetuses with ARSA and other structural abnormal-ities,cardiovascular system accounted for the highest proportion(44.4％),followed by nervous system(22.2％)and urinary system(22.2％).Through genetic analysis,8.3％(4/48)fetuses with isolated ARSA and 40.0％(4/10)fetuses with complicated ARSA were found to have chromosomal numerical or structural abnormalities,with statis-tically significant difference between the two groups(P=0.024).Genetic analysis was completed in 48 isolated ARSA,and the positive rate of pathogenic copy number variants(CNV)was 4.2％(2/48),which was not signifi-cantly different from the pathogenic CNV incidence rate of 0.4％(1/239)in elderly pregnant cases during the same period(P=0.074).The Down syndrome positive likelihood ratio(LR+)for isolated ARSA was 2.5 and the Down syndrome LR+for complicated ARSA was 49.6.Conclusions:Complicated ARSA is often associated with cardiovascular abnormalities and is more likely to develop Down syndrome than isolated ARSA.Although the inci-dence of pCNV in isolated ARSA is slightly higher than the natural incidence,the correlation between pCNV and i-solated ARSA has not been clearly determined by the current sample size.

Objective:To investigate the clinical significance of prenatal screening and genetic analysis in the diagnosis of fetal aberrant right subclavian artery(ARSA).Methods:The ultrasonographic features of ARSA fetu-ses detected by prenatal ultrasound at the University of Hong Kong-Shenzhen Hospital from October 2017 to March 2022 were retrospectively analyzed.The fetuses were divided into isolated ARSA group and complicated ARSA group.Their genetic analysis results and pregnancy outcome were analyzed.Results:Among 30,260 preg-nant women,185 fetuses were diagnosed with ARSA by prenatal ultrasound screening,with an incidence of 0.6％;5 fetuses(2.6％)were diagnosed by ultrasound in the first trimester,and the remaining were diagnosed by fetal grade Ⅲ structural ultrasound examination at 20～24 weeks' gestation.Among them,158 fetuses(85.4％)had isolated ARSA,and 27(14.6％)had complicated ARSA.Among fetuses with ARSA and other structural abnormal-ities,cardiovascular system accounted for the highest proportion(44.4％),followed by nervous system(22.2％)and urinary system(22.2％).Through genetic analysis,8.3％(4/48)fetuses with isolated ARSA and 40.0％(4/10)fetuses with complicated ARSA were found to have chromosomal numerical or structural abnormalities,with statis-tically significant difference between the two groups(P=0.024).Genetic analysis was completed in 48 isolated ARSA,and the positive rate of pathogenic copy number variants(CNV)was 4.2％(2/48),which was not signifi-cantly different from the pathogenic CNV incidence rate of 0.4％(1/239)in elderly pregnant cases during the same period(P=0.074).The Down syndrome positive likelihood ratio(LR+)for isolated ARSA was 2.5 and the Down syndrome LR+for complicated ARSA was 49.6.Conclusions:Complicated ARSA is often associated with cardiovascular abnormalities and is more likely to develop Down syndrome than isolated ARSA.Although the inci-dence of pCNV in isolated ARSA is slightly higher than the natural incidence,the correlation between pCNV and i-solated ARSA has not been clearly determined by the current sample size.

ObjectiveTo investigate the relationship between serum 25(OH)D and gestational diabetes mellitus in the second trimester (GDM), to analyze the interaction effect of key risk factors, so as to provide a basis for clinical personalized vitamin D supplementation. MethodsA total of 266 pregnant women who registered and took regular obstetric check-ups in Shanghai Pudong New Area Health Care Hospital for Women and Children from June to December 2022, were selected as the research subjects. According to the results of oral glucose tolerance test (OGTT), the subjects were divided into the GDM group (131) and control group (135). The level of serum 25(OH)D at the time of OGTT were detected and other clinical indicators were followed up. ResultsThe age, systolic blood pressure in early pregnancy, pre-pregnancy BMI, FPG, OGTT 1-hour and 2-hour glucose, GHb, HOMA-IR, TG, AST, Cr, D-D, FDP and SF at 35 weeks’ gestation of the pregnant women were higher in the GDM group than that of the pregnant women in the normal group, while gestational weight gain and serum 25(OH)D level were significantly lower than that of the pregnant women in the normal group. Serum 25(OH)D was negatively correlated with HOMA-IR and WBS’s, but positively correlated with TG and ALT. Serum 25(OH)D was non-linearly correlated with the risk of GDM in an inverted J-shape, and there was an interaction effect of advanced age, pre-pregnancy obesity and vitamin D deficiency on the risk of GDM. ConclusionVitamin D is non-linearly associated with the risk of GDM. The risk of GDM is significantly reduced when serum 25(OH)D level ≥30 ng∙mL^-1.

Hyperaldosteronism is a common disease that is closely related to endocrine hypertension and other cardiovascular diseases. Cytochrome P450 11B2 (CYP11B2), an important enzyme in aldosterone (ALD) synthesis, is a promising target for the treatment of hyperaldosteronism. However, selective inhibitors targeting CYP11B2 are still lacking due to the high similarity with CYP11B1. In this study, atractylenolide-I (AT-I) was found to significantly reduce the production of ALD but had no effect on cortisol synthesis, which is catalyzed by CYP11B1. Chemical biology studies revealed that due to the presence of Ala320, AT-I is selectively bound to the catalytic pocket of CYP11B2, and the C8/C9 double bond of AT-I can be epoxidized, which then undergoes nucleophilic addition with the sulfhydryl group of Cys450 in CYP11B2. The covalent binding of AT-I disrupts the interaction between heme and CYP11B2 and inactivates CYP11B2, leading to the suppression of ALD synthesis; AT-I shows a significant therapeutic effect for improving hyperaldosteronism.

Objective:To investigate the association between the polymorphisms of the hypothalamus pituitary adrenal axis related genes SKA2, AVPR1B, CRHR2 and suicide attempts in patients with depression, and the interaction between the genes and environmental factors.Methods:From March 2017 to August 2018, sixty-one patients with depression who were hospitalized for suicide were selected (case group), and 57 subjects matched with the age, gender and education level of the case group (control group) were selected in the same period.Snapshot genotyping technique was used to test the genotypes of case group and control group.Barratt impulsivity scale (BIS-Ⅱ) and life event scale (LES) were used to assess the impulsive traits and mental stress of individuals in the past year.Chi-square test and independent sample t-test were used for inter group comparison by SPSS 22.0 software.Gene-environment interaction was analyzed by the generalized multi factor dimensionality reduction. Results:The total scores of BIS-Ⅱ and LES in case group(65.05± 11.14, 34.16±27.23) were higher than those in the control group (53.30 ± 9.07, 11.67±12.64), the differences were statistically significant (both P<0.05). There was no significant difference in gene frequency and allele frequency of SKA2 and CRHR2 between the two groups ( P>0.05). The genotype frequency and allele frequency of rs28373064 of AVPR1B gene were significantly different between the two groups (χ 2=5.763, 4.279, both P<0.05), but there was no significant difference after Bonferroni correction ( P>0.05). The best interaction model in GMDR was the third-order model constructed by rs28373064 of AVPR1B gene, impulsive traits and life events, with the highest accuracy of 0.789 for sample test( P=0.001). In multiple genetic models, rs28373064 of AVPR1B gene was associated with attempted suicide behavior in patients with depression(dominant model: A/G-G/G ( OR=0.38, 95% CI=0.16-0.88, P=0.021), overdominant model: A/G ( OR=0.36, 95% CI=0.15-0.87, P=0.019), log-additive model: A/A, A/G and G/G ( OR=0.44, 95% CI=0.20-0.96, P=0.034)). Conclusion:rs28373064 polymorphism of AVPR1B gene is associated with attempted suicide behavior in patients with depression.AA genotype carriers of AVPR1B gene are more likely to commit suicide under the influence of life events and impulsive.

Silibinin exhibits antidiabetic potential by preserving the mass and function of pancreatic β-cells through up-regulation of estrogen receptor-α (ERα) expression. However, the underlying protective mechanism of silibinin in pancreatic β-cells is still unclear. In the current study, we sought to determine whether ERα acts as the target of silibinin for the modulation of antioxidative response in pancreatic β-cells under high glucose and high fat conditions. Our in vivo study revealed that a 4-week oral administration of silibinin (100 mg/kg/day) decreased fasting blood glucose with a concurrent increase in levels of serum insulin in high-fat diet/streptozotocin-induced type 2 diabetic rats. Moreover, expression of ERα, NF-E2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) in pancreatic β-cells in pancreatic islets was increased by silibinin treatment. Accordingly, silibinin (10 μM) elevated viability, insulin biosynthesis, and insulin secretion of high glucose/palmitate-treated INS-1 cells accompanied by increased expression of ERα, Nrf2, and HO-1 as well as decreased reactive oxygen species production in vitro. Treatment using an ERα antagonist (MPP) in INS-1 cells or silencing ERα expression in INS-1 and NIT-1 cells with siRNA abolished the protective effects of silibinin. Our study suggests that silibinin activates the Nrf2-antioxidative pathways in pancreatic β-cells through regulation of ERα expression.

Objective:Dipeptidyl peptidase I(DPPI),a lysosomal cysteine protease for serine proteases activation,highly expressed in granule immune cells.This study used collagen induced arthritis(CIA) rat model to investigate the effects of Triperygium Wilfordii Polyglucoside(TWP) on DPPI activity and the pharmacological mechanism in RA treatment.Methods:Rats were divided into four groups randomly,the blank control group,the CIA model group,the high dose (5.0 mg/100 g body-weight) and low dose(2.5 mg/100 g body-weight)treatment group.Bovine collagen-Ⅱ plus complete Freund′s adjuvant injected twice in rats.Physical assessments were carried out.12 days post-injections,the rats of treatment group were intragastric administered with TWP every day.The rats were killed after two week administrations.Serum and synovial membrane homogenates were collected and DPPI activity was detected by fluorescence substrate.Joint HE staining and cell counting were carried out,Zymography was used to detect the MMP-2/9 activity in synovial fluids.Total protein in synovial membrane homogenates were measured by BCA method.Results:TWP could reduce the number of CIA synovial tissue mast cells,inhibited DPPI activity in the synovial fluids and in serum.The expression levels of MMP-2/9 activity and synovium total protein content were also reduced by TWP.Conclusion:Triperygium Wilfordii Polyglucoside has inhibitory effects on DPPI activity on CIA rats,which might be the one of the pharmacological mechanisms in RA treatment.

Objective To investigate the effect of postoperative analgesia nursing on the comfort degree of laparotomy patients in hepatobiliary surgery department.Methods A total of 86 laparotomy patients in our department were randomly divided into observation group and control group,receiving postoperative analgesia nursing and routine nursing,respectively.And postoperative analgesia and postoperative comfort were compared.Results The postoperative pain degree in the observation group was less than that in the control group,the incidence of incomplete analgesia was lower than that in the control group,pain call frequency in the operation day,1 day after operation,and 2 day after operation was lower than that in the control group,the difference was statistically significant (P ＜0.05).Comfort of physiological,psychological,social and cultural aspects in the observation group were higher than that in the control group,nursing satisfaction was higher than the control group,the difference was statistically significant (P ＜ 0.05).Conclusion Postoperative analgesia nursing can significantly reduce degree of pain of laparotomy patients in hepatobiliary surgery department,and improve the postoperative comfort and nursing satisfaction.

Objective To investigate the effect of postoperative analgesia nursing on the comfort degree of laparotomy patients in hepatobiliary surgery department.Methods A total of 86 laparotomy patients in our department were randomly divided into observation group and control group,receiving postoperative analgesia nursing and routine nursing,respectively.And postoperative analgesia and postoperative comfort were compared.Results The postoperative pain degree in the observation group was less than that in the control group,the incidence of incomplete analgesia was lower than that in the control group,pain call frequency in the operation day,1 day after operation,and 2 day after operation was lower than that in the control group,the difference was statistically significant (P ＜0.05).Comfort of physiological,psychological,social and cultural aspects in the observation group were higher than that in the control group,nursing satisfaction was higher than the control group,the difference was statistically significant (P ＜ 0.05).Conclusion Postoperative analgesia nursing can significantly reduce degree of pain of laparotomy patients in hepatobiliary surgery department,and improve the postoperative comfort and nursing satisfaction.

OBJECTIVETo compare the difference between the acupoint embedding therapy and polyene phosphatidylcholine capsules in the clinical efficacy on non-alcoholic fatty liver disease (NAFLD) of liver stagnation and spleen deficiency pattern.

METHODSThe multi-center clinical trial was adopted and 180 cases of NAFLD of liver stagnation and spleen deficiency pattern were randomized into an embedding therapy group and a western medication group, 90 cases in each one. On the basis of general treatment such as diet control and proper physical exercise, in the embedding therapy group, the acupoint embedding therapy was applied to Ganshu (BL 18), Tai-chong (LR 3), Fenglong (ST 40), Zusanli (ST 36) and Sanyinjiao (SP 6), once every 7 days; in the western medication group, polyene phosphatidylcholine capsules (essentiale) were prescribed, 228 mg/capsule, 2 capsules each time, three times a day. In 6 months of treatment, TCM syndrome score, liver enzymology, blood lipid and abdomen B-ultrasound examination were observed and compared before and after treatment between the two groups.

RESULTS(1) For TCM syndrome score, the total score in the embedding therapy group was lower significantly than that in the western medication group (P<0. 05); (2) For liver enzymology and blood lipid, the levels of serum alanine transarninase (ALT), serum glutamic oxalacetic transaminase (AST), total cholesterol (TC) and triacylglycerol (TG) in the embedding therapy group were reduced significantly as compared with those in the western medication group (all P<0. 05); (3) For abdomen B-ultrasound examination, the fatty liver degree in the embedding therapy group was relieved significantly as compared with that in the western medication group (P< 0. 05); (4) For clinical efficacy, the total effective rate was 89. 8%o (79/88) in the embedding therapy group, higher significantly than 76. 7% (69/90) in the western medication group(P<0. 05).

CONCLUSIONThe acupoint embedding therapy achieves the definite efficacy on NAFLD of liver stagnation and spleen deficiency pattern, better than polyene phosphatidylcholine capsules.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Catgut ; utilization ; Female ; Humans ; Liver ; physiopathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; physiopathology ; therapy ; Spleen ; physiopathology ; Treatment Outcome ; Young Adult