Objective To evaluate the safety and feasibility of percutaneous mitral balloon valvuloplasty with the assistance of arterio-venous circuit.Methods From January 2015 to October 2022,a total 25 patients[19 females,6 males;age(61.60±9.00)years]were included,who were diagnosed with rheumatic heart disease and severe mitral stenosis.A transseptal puncture was performed to establish a femoral arterio-venous circuit,followed by graded dilation with Inoue balloon(diameters:22.00 mm to 28.00 mm).The target was a mitral valve area≥1.50 cm2 with mild or less regurgitation.Results The arterio-venous circuit was established,and mitral balloon valvuloplasty was successfully completed in all 25 patients.Among them,20 patients experienced difficulty with transvalvular crossing using the balloon catheter with conventional methods,16 patients had valvular severe calcification,and 3 patients presented with a left atrial appendage thrombus despite of more than 6-month anticoagulation therapy with warfarin.The mean balloon diameter was(25.00±1.40)mm.The mitral valve area increased from(0.91±0.15)cm2 preoperatively to(1.70±0.14)cm2 postoperatively(P＜0.001).Mean left atrial pressure decreased from(27.00±7.50)mmHg to(16.36±4.07)mmHg(P＜0.001),and mean pulmonary artery pressure decreased from(40.84±13.81)mmHg to(25.00±7.12)mmHg(P＜0.001).All patients showed significant symptom improvement with no complications.Conclusions Arterio-venous circuit for percutaneous mitral balloon valvuloplasty is safe and feasible.This technique can serve as an alternative to standard technique for patients with complex mitral stenosis.

Objective To investigate the feasibility and safety of bedside transesophageal echocardiography(TEE)-guided atrial septostomy in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods Eight patients(2 females and 6 males)who developed pulmonary edema during VA-ECMO treatment between January 2020 and October 2024 were enrolled.All patients underwent bedside TEE-guided atrial septal puncture,followed by gradual balloon dilation using an Inoue balloon(diameter:18-24 mm).The endpoint for dilation was defined as mean left atrial pressure＜15 mmHg.Post-procedure evaluation included assessment of the septal defect size,mean left atrial pressure,and improvement in bilateral pulmonary edema.Results The mean age of all 8 patients was(43.50±16.84)years old.Atrial septostomy was successfully performed in all patients.The mean balloon dilation diameter was(22.75±2.68)mm,resulting in a mean septal defect size of(6.31±0.37)mm.The mean left atrial pressure significantly decreased from(26.63±1.77)mmHg pre-procedure to(12.75±1.28)mmHg post-procedure(P＜0.001).All patients demonstrated marked improvement in bilateral pulmonary edema,and six patients also showed a significant reduction in the severity of mitral regurgitation following the procedure.No procedure-related complications were observed.Conclusions Bedside TEE-guided atrial septostomy is safe and effective for reducing left heart loading during ECMO support and improving pulmonary edema.

OBJECTIVE To analyze the differences in chemical composition of mussels from Shengsi,Zhoushan in different har-vest months,and to compare the differences in the composition of mussels from different origins,so as to provide ideas for the compre-hensive utilization of its resources.METHODS Ultra-high performance liquid chromatography-triple quadrupole mass spectrometry(UHPLC-QqQ-MS)and spectrophotometry were used to analyze and evaluate the contents of nucleosides,amino acids,water-soluble proteins,total sugars and polysaccharides in mussels from Shengsi,Zhoushan in 12 months of the year and from 5 different origins;principal component analysis(PCA),partial least squares discriminant method(PLS-DA)and TOPSIS method were used to compre-hensively evaluate mussels.RESULTS A total of 16 amino acids and 11 nucleosides were detected in mussels.The average content of total amino acids in Shengsi mussels throughout the year was 4 851.74 μg·g-1,the average content of total nucleosides was 921.40 μg·g-1,and the average contents of water-soluble protein,polysaccharides,and total sugars were 51.32 mg·g-1,74.39 μg·g-1,and 417.22 mg·g-1,respectively.The nucleosides of Shengsi mussels were the highest in March and April,the ami-no acids and water-soluble proteins were the highest in April and May,and the polysaccharides and total sugars were the highest in Oc-tober and November.The PCA and PLS-DA results of the chemical components of different resources showed that there were great differences in Shengsi mussel samples harvested in different seasons.The entropy weight TOPSIS analysis showed that the comprehen-sive scores of Shengsi mussels in March and April(S7 and S8)were better than those in other areas,and the comprehensive score of Shengsi mussels in April(S8)was the highest,which was determined to be the best harvesting month.CONCLUSION The comparison results of multi-type resource chemistry show that there are great differences in the chemical compo-sition of Shengsi mussels in different harvesting seasons;the quality of Shengsi mussels is better than that of other areas;April is the best harvesting season,providing a reference for the quality evaluation and comprehensive development and utilization of mussels.

Objective To investigate the feasibility and safety of bedside transesophageal echocardiography(TEE)-guided atrial septostomy in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods Eight patients(2 females and 6 males)who developed pulmonary edema during VA-ECMO treatment between January 2020 and October 2024 were enrolled.All patients underwent bedside TEE-guided atrial septal puncture,followed by gradual balloon dilation using an Inoue balloon(diameter:18-24 mm).The endpoint for dilation was defined as mean left atrial pressure＜15 mmHg.Post-procedure evaluation included assessment of the septal defect size,mean left atrial pressure,and improvement in bilateral pulmonary edema.Results The mean age of all 8 patients was(43.50±16.84)years old.Atrial septostomy was successfully performed in all patients.The mean balloon dilation diameter was(22.75±2.68)mm,resulting in a mean septal defect size of(6.31±0.37)mm.The mean left atrial pressure significantly decreased from(26.63±1.77)mmHg pre-procedure to(12.75±1.28)mmHg post-procedure(P＜0.001).All patients demonstrated marked improvement in bilateral pulmonary edema,and six patients also showed a significant reduction in the severity of mitral regurgitation following the procedure.No procedure-related complications were observed.Conclusions Bedside TEE-guided atrial septostomy is safe and effective for reducing left heart loading during ECMO support and improving pulmonary edema.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Gene regulation relies on the precise binding of transcription factors (TFs) at regulatory elements, but simultaneously detecting hundreds of TFs on chromatin is challenging. We developed cFOOT-seq, a cytosine deaminase-based TF footprinting assay, for high-resolution, quantitative genome-wide assessment of TF binding in both open and closed chromatin regions, even with small cell numbers. By utilizing the dsDNA deaminase SsdAtox, cFOOT-seq converts accessible cytosines to uracil while preserving genomic integrity, making it compatible with techniques like ATAC-seq for sensitive and cost-effective detection of TF occupancy at the single-molecule and single-cell level. Our approach enables the delineation of TF footprints, quantification of occupancy, and examination of chromatin influences on TF binding. Notably, cFOOT-seq, combined with FootTrack analysis, enables de novo prediction of TF binding sites and tracking of TF occupancy dynamics. We demonstrate its application in capturing cell type-specific TFs, analyzing TF dynamics during reprogramming, and revealing TF dependencies on chromatin remodelers. Overall, cFOOT-seq represents a robust approach for investigating the genome-wide dynamics of TF occupancy and elucidating the cis-regulatory architecture underlying gene regulation.
Transcription Factors/genetics* ; Humans ; Chromatin/genetics* ; Animals ; Binding Sites ; Mice ; DNA Footprinting/methods*

Objective:To explore the mechanism of G protein-coupled receptor 120(GPR120)regulating nod-like receptor family pyrin domain containing 3(NLRP3)inflammasome-mediated inflammatory response in polycystic ovary syndrome(PCOS).Methods:Forty-five wild-type female C57BL/6J mice were randomly divided into three groups:control group,model group,and TUG-891 group,with 15 mice in each group.The model and TUG-891 groups were subcutaneously implanted with 35-day testosterone(T)continuous-release pellets to induce the PCOS model,while control mice received placebo pills.Mice in the TUG-891 group were treated with daily in-traperitoneal injections of TUG-891 starting from day 21 after T implantation.The model group and the control group were injected with the same amount of normal saline intraperitoneally.At the end of the experiment(day 35),the mice were euthanized,and blood and ovarian tissue samples were collected.Immunofluorescence stai-ning was used to detect the expression of GPR120 and NLRP3 proteins in ovarian tissues.Sirius Red staining was performed to detect ovarian fibrosis.Western blot analysis was used to measure the expression of fibrosis factors:α-smooth muscle actin(α-SMA),matrix metalloproteinase 2(MMP2),transforming growth factor-β1(TGF-β1),and inflammatory factors NLRP3,Toll-like receptor 4(TLR4),and tumor necrosis factor-α(TNF-α)in tissues.O-varian granulosa cells(GCs)were isolated from female mice and cultured in DMEM-F12 medium containing 10%fetal bovine serum and 1%penicillin-streptomycin.The cells were divided into the control group,TUG-891 group,T group,and T+TUG-891 group.The vitality and apoptosis of GCs were analyzed using the MTT assay and flow cytometry,respectively.Results:Compared with the model group,the TUG-891 group showed significant increa-ses in body growth,ovarian weight,ovarian index,and the number of pre-ovulatory follicles(P<0.05),as well as significant reductions in sex hormones T,estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)levels and atretic follicle numbers(P<0.05).Compared with the model group,the Sirius red staining and the relative expressions of α-SMA,MMP2,and TGF-β1 in the ovarian tissue of the TUG-891 group were signifi-cantly lower(P<0.05).Compared with the model group,the expression of GRP120 in the ovarian tissue of the TUG-891 group was significantly increased(P<0.05),and the expression of NLRP3 was significantly decreased(P<0.05).In the in vitro experiments,compared with the T group,the T+TUG-891 group significantly increased the proliferation of GCs(P<0.05),and the apoptosis of GCs and the protein expressions of NLRP3,TLR4 and TNF-α in GCs were significantly decreased(P<0.05).Conclusions:The GPR120 agonist TUG-891 may reduce the chronic low-grade inflammation induced by hyperandrogenism in PCOS mice by inhibiting the production of NLRP3 inflammasome,thereby protecting the growth and development of ovaries and follicles in mice.

Objective:To explore the mechanism of G protein-coupled receptor 120(GPR120)regulating nod-like receptor family pyrin domain containing 3(NLRP3)inflammasome-mediated inflammatory response in polycystic ovary syndrome(PCOS).Methods:Forty-five wild-type female C57BL/6J mice were randomly divided into three groups:control group,model group,and TUG-891 group,with 15 mice in each group.The model and TUG-891 groups were subcutaneously implanted with 35-day testosterone(T)continuous-release pellets to induce the PCOS model,while control mice received placebo pills.Mice in the TUG-891 group were treated with daily in-traperitoneal injections of TUG-891 starting from day 21 after T implantation.The model group and the control group were injected with the same amount of normal saline intraperitoneally.At the end of the experiment(day 35),the mice were euthanized,and blood and ovarian tissue samples were collected.Immunofluorescence stai-ning was used to detect the expression of GPR120 and NLRP3 proteins in ovarian tissues.Sirius Red staining was performed to detect ovarian fibrosis.Western blot analysis was used to measure the expression of fibrosis factors:α-smooth muscle actin(α-SMA),matrix metalloproteinase 2(MMP2),transforming growth factor-β1(TGF-β1),and inflammatory factors NLRP3,Toll-like receptor 4(TLR4),and tumor necrosis factor-α(TNF-α)in tissues.O-varian granulosa cells(GCs)were isolated from female mice and cultured in DMEM-F12 medium containing 10%fetal bovine serum and 1%penicillin-streptomycin.The cells were divided into the control group,TUG-891 group,T group,and T+TUG-891 group.The vitality and apoptosis of GCs were analyzed using the MTT assay and flow cytometry,respectively.Results:Compared with the model group,the TUG-891 group showed significant increa-ses in body growth,ovarian weight,ovarian index,and the number of pre-ovulatory follicles(P<0.05),as well as significant reductions in sex hormones T,estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)levels and atretic follicle numbers(P<0.05).Compared with the model group,the Sirius red staining and the relative expressions of α-SMA,MMP2,and TGF-β1 in the ovarian tissue of the TUG-891 group were signifi-cantly lower(P<0.05).Compared with the model group,the expression of GRP120 in the ovarian tissue of the TUG-891 group was significantly increased(P<0.05),and the expression of NLRP3 was significantly decreased(P<0.05).In the in vitro experiments,compared with the T group,the T+TUG-891 group significantly increased the proliferation of GCs(P<0.05),and the apoptosis of GCs and the protein expressions of NLRP3,TLR4 and TNF-α in GCs were significantly decreased(P<0.05).Conclusions:The GPR120 agonist TUG-891 may reduce the chronic low-grade inflammation induced by hyperandrogenism in PCOS mice by inhibiting the production of NLRP3 inflammasome,thereby protecting the growth and development of ovaries and follicles in mice.

OBJECTIVE To analyze the differences in chemical composition of mussels from Shengsi,Zhoushan in different har-vest months,and to compare the differences in the composition of mussels from different origins,so as to provide ideas for the compre-hensive utilization of its resources.METHODS Ultra-high performance liquid chromatography-triple quadrupole mass spectrometry(UHPLC-QqQ-MS)and spectrophotometry were used to analyze and evaluate the contents of nucleosides,amino acids,water-soluble proteins,total sugars and polysaccharides in mussels from Shengsi,Zhoushan in 12 months of the year and from 5 different origins;principal component analysis(PCA),partial least squares discriminant method(PLS-DA)and TOPSIS method were used to compre-hensively evaluate mussels.RESULTS A total of 16 amino acids and 11 nucleosides were detected in mussels.The average content of total amino acids in Shengsi mussels throughout the year was 4 851.74 μg·g-1,the average content of total nucleosides was 921.40 μg·g-1,and the average contents of water-soluble protein,polysaccharides,and total sugars were 51.32 mg·g-1,74.39 μg·g-1,and 417.22 mg·g-1,respectively.The nucleosides of Shengsi mussels were the highest in March and April,the ami-no acids and water-soluble proteins were the highest in April and May,and the polysaccharides and total sugars were the highest in Oc-tober and November.The PCA and PLS-DA results of the chemical components of different resources showed that there were great differences in Shengsi mussel samples harvested in different seasons.The entropy weight TOPSIS analysis showed that the comprehen-sive scores of Shengsi mussels in March and April(S7 and S8)were better than those in other areas,and the comprehensive score of Shengsi mussels in April(S8)was the highest,which was determined to be the best harvesting month.CONCLUSION The comparison results of multi-type resource chemistry show that there are great differences in the chemical compo-sition of Shengsi mussels in different harvesting seasons;the quality of Shengsi mussels is better than that of other areas;April is the best harvesting season,providing a reference for the quality evaluation and comprehensive development and utilization of mussels.