Objective To evaluate the impact of an integrated management mode of prenatal diagnosis-postnatal treatment for congenital heart disease (CHD) on perioperative and long-term outcomes of the arterial switch operation (ASO), and to analyze the efficacy of ASO in a single center. Methods This retrospective study analyzed the clinical data of 183 children who underwent ASO at Guangdong Provincial People’s Hospital from 2018 to 2024. The cohort included 106 (57.9%) patients of transposition of the great arteries with intact ventricular septum (TGA/IVS), 61 (33.3%) patients of transposition of the great arteries with ventricular septal defect (TGA/VSD), and 16 (8.7%) patients of Taussig-bing anomaly (TBA). Perioperative indicators were compared between 91 patients in the prenatal-postnatal integrated management group (an integrated group) and 92 patients in the traditional management group (a non-integrated group). Long-term survival and reoperation rates were analyzed using Kaplan-Meier curves. Results The overall perioperative mortality rate was 4.9% (9/183), showing a downward trend year by year. The primary cause of perioperative mortality was low cardiac output syndrome (LCOS), which occurred in 12 patients (6.6% incidence) with a mortality rate of 75.0%. The integrated group had a higher proportion of males (89.0% vs. 72.8%, P<0.05) and lower body weight [3.1 (2.7, 3.3) kg vs. 3.3 (3.0, 3.7) kg, P<0.05] compared to the non-integrated group. The age at surgery was significantly earlier in the integrated group [7 (3, 10) d vs. 14 (9, 48) d, P<0.05], and all children in the integrated group underwent ASO within the optimal surgical window (100.0% vs. 82.6%, P<0.05). Intraoperatively, cardiopulmonary bypass time [173 (150, 207) min vs. 186 (159, 237) min, P<0.05] and aortic cross-clamp time [100 (90, 117) min vs. 116 (97, 142) min, P<0.05] were significantly shorter in the integrated group. Although the integrated group had longer postoperative mechanical ventilation time [145 (98, 214) h vs. 116 (77, 147) h, P<0.05] and higher 48-hour maximum vasoactive inotropic score [15 (10, 21) points vs. 12 (8, 16) points, P<0.05], there was no statistically significant difference in the incidence of severe complications (LCOS, necrotizing enterocolitis, extracorporeal membrane oxygenation) or mortality rate (3.3% vs. 6.5%, P=0.51) between the two groups, despite earlier surgical intervention and a higher proportion of critically ill cases in the integrated group. The length of hospital stay in the emergency surgery group was significantly shorter than that in the elective surgery group [20 (15, 28) d vs. 25 (21, 30) d, P<0.05], suggesting that early surgery may be of potential benefit. A total of 163 patients were successfully followed up for a median of 4.7 years, with a 5-year survival rate of 95.1% and a freedom from reintervention survival rate of 95.1%. There were no late deaths, and the most common postoperative complication was pulmonary artery stenosis. Conclusion The integrated management model allowed critically ill children with lower body weights to safely undergo surgery, significantly optimizing the timing of surgery and shortening intraoperative times. The long-term risk of reoperation after ASO is primarily concentrated on pulmonary artery stenosis, necessitating long-term follow-up and monitoring.

To explore the effects and processes of various hesperidin(HP)dosages on atherosclero-sis(AS)in rabbits caused by high-fat diet in conjunction with anhydrous ethanol arterial damage.A total of twenty-five healthy male rabbits,six months of age,were chosen,given a week to accli-mate and feed,and then randomly assigned to five groups:the model group,the control group,and the groups receiving low,middle,and high doses of HP.The control group received normal feed during the experiment;the model group received high-fat feed for 30 days,after which the common carotid artery was perfused with anhydrous ethanol to create a pathological model of AS;the HP low,middle,and high dose groups received high-fat feed continuously for 30 days based on the model group,with 100,150,and 200 mg/kg of HP added to the diets,respectively.The blood cell counts,including white blood cells(WBC),lymphocytes(lym),monocytes(Mon),red blood cells(RBC),hemoglobin concentration(HGB),platelet count(PLT),and granulocytes were measured using hematology analyzer.The serum total cholesterol(TC),triglycerides(TG),low density lipo-protein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were analyzed u-sing biochemical analyzer.An ELISA kit was used to measure the expression of inflammatory factors and the level of oxidative factors,while a blood cell analyzer was used to measure the quan-tity of blood cells and a biochemical analyzer was used to measure the level of four kinds of blood lipids.At the end of the test,the test rabbits were sacrificed to take carotid arteries for pathological tissue sections HE,Oil Red O and Masson staining to observe the structure of the wall with lipid infiltration and other conditions.The results indicated a significant increase in body weight in the model group compared to the HP dose group(P＜0.01).In comparison to the model group,HP in-tervention significantly reduced the levels of WBC,Mon,PLT,and the percentage of Gran(P＜0.01).Additionally,HP intervention significantly decreased serum inflammatory cytokines,inclu-ding TG,TC,and LDL-C,while increasing HDL-C levels(P＜0.01).The plasma levels of TNF-αand IL-1 decreased significantly following HP intervention(P＜0.01),whereas the level of IL-10 increased significantly(P＜0.01).Furthermore,SOD activity was significantly higher(P＜0.01)and MDA content was significantly lower(P＜0.01)after HP intervention.Histological examina-tion revealed that HP intervention significantly reduced lipid deposition in tubular walls,inflamma-tory cell infiltration,and the extent of elastic fiber damage.These results suggest that HP may at-tenuate atherosclerosis in rabbits by modulating lipid levels,inflammatory factors,and oxidative stress.

To explore the effects and processes of various hesperidin(HP)dosages on atherosclero-sis(AS)in rabbits caused by high-fat diet in conjunction with anhydrous ethanol arterial damage.A total of twenty-five healthy male rabbits,six months of age,were chosen,given a week to accli-mate and feed,and then randomly assigned to five groups:the model group,the control group,and the groups receiving low,middle,and high doses of HP.The control group received normal feed during the experiment;the model group received high-fat feed for 30 days,after which the common carotid artery was perfused with anhydrous ethanol to create a pathological model of AS;the HP low,middle,and high dose groups received high-fat feed continuously for 30 days based on the model group,with 100,150,and 200 mg/kg of HP added to the diets,respectively.The blood cell counts,including white blood cells(WBC),lymphocytes(lym),monocytes(Mon),red blood cells(RBC),hemoglobin concentration(HGB),platelet count(PLT),and granulocytes were measured using hematology analyzer.The serum total cholesterol(TC),triglycerides(TG),low density lipo-protein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were analyzed u-sing biochemical analyzer.An ELISA kit was used to measure the expression of inflammatory factors and the level of oxidative factors,while a blood cell analyzer was used to measure the quan-tity of blood cells and a biochemical analyzer was used to measure the level of four kinds of blood lipids.At the end of the test,the test rabbits were sacrificed to take carotid arteries for pathological tissue sections HE,Oil Red O and Masson staining to observe the structure of the wall with lipid infiltration and other conditions.The results indicated a significant increase in body weight in the model group compared to the HP dose group(P＜0.01).In comparison to the model group,HP in-tervention significantly reduced the levels of WBC,Mon,PLT,and the percentage of Gran(P＜0.01).Additionally,HP intervention significantly decreased serum inflammatory cytokines,inclu-ding TG,TC,and LDL-C,while increasing HDL-C levels(P＜0.01).The plasma levels of TNF-αand IL-1 decreased significantly following HP intervention(P＜0.01),whereas the level of IL-10 increased significantly(P＜0.01).Furthermore,SOD activity was significantly higher(P＜0.01)and MDA content was significantly lower(P＜0.01)after HP intervention.Histological examina-tion revealed that HP intervention significantly reduced lipid deposition in tubular walls,inflamma-tory cell infiltration,and the extent of elastic fiber damage.These results suggest that HP may at-tenuate atherosclerosis in rabbits by modulating lipid levels,inflammatory factors,and oxidative stress.

Prevotella copri and its related taxa are widely detected in mammalian gut microbiomes and have been linked with an enterotype in humans.However,their microevolution and macroevolution among hosts are poorly characterized.In this study,extensively collected marker genes and genomes were analyzed to trace their evolutionary history,host specificity,and biogeographic distribution.Investigations based on marker genes and genomes suggest that a P.copri-containing lineage(PCL)harbors diverse species in higher primates.Firstly,P.copri in the human gut consisted of multiple groups exhibiting high genomic divergence and conspicuous but non-strict biogeographic patterns.Most African strains with high genomic divergence from other strains were phylogenetically located at the root of the species,indicating the co-evolutionary his-tory of P.copri and Homo sapiens.Secondly,although long-term co-evolution between PCL and higher primates was revealed,sporadic signals of co-speciation and extensive host jumping of PCL members were suggested among higher primates.Metagenomic and phylogenetic analyses indicated that P.copri and other PCL species found in domesticated mammals had been recently transmitted from humans.Thirdly,strong evidence was found on the extensively horizontal transfer of genes(e.g.,genes encoding carbohydrate-active enzymes)among sympatric P.copri groups and PCL species in the same primate host.Our study provides panoramic insights into the combined effects of vertical and horizontal transmission,as well as potential niche adaptation,on the microevolutionary and macroevolutionary history for an enterotype-representative lineage.

Objective To analyze the risk factors of low birth weight (LBW) in infants who were conceived through flesh embryo transfer after in vitro fertilization.Methods We retrospectively reviewed the medical records of 4 930 live babies born after in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) at Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University between January 2011 to December 2016.They were 3 474 singletons and 1 456 pairs of dizygotic twins.According to their birth weight,all singletons were divided into two groups:the LBW singleton group (＜2 500 g,n=252) and the control singleton group (≥ 2 500 g,n=3 222).Two dizygotic twin groups,the LBW dizygotic twin group (＜2 500 g,n=1 014) and the control dizygntic twin group (≥ 2 500 g,n=442),were set up as well.Clinical characteristics of the infants in different groups and risk factors of LBW were analyzed.Independent samples t-test,Mann-Whitney U test,Chi-square test,and logistic regression were used for statistical analysis.Results (1) The rates of LBW were 7.25％ (252/3 474) in singletons and 69.64％ (1 014/1 456) in dizygotic twins.(2) In singleton pregnancies,the maternal body mass index (BMI) of the LBW group was lower than that of the control group [(20.9± 2.8) vs (21.3 ± 2.7) kg/m2,t=-2.162,P=0.031],while the rates of preterm delivery and blastocyst transfer were higher [61.7％ (153/252) vs 5.7％ (182/3 222),8.7％ (22/252) vs 5.1％ (163/3 222),x2=814.232 and 6.234,respectively,all P＜0.05].(3) In dizygotic twin pregnancies,maternal age,paternal age,the rate of preterm delivery and estradiol (E2) level [M(P25-P75)] at trigger were higher than those of the control group [(31.0±3.7)vs (30.5±3.9) years,(33.7±5.0) vs (32.7±4.5) years,63.0％ (631/1 014) vs 28.0％ (123/442),11 362.3 (7 549.2-16 716.1) vs 10 444.8(7 079.4-14 569.9) pmol/L;the values of t or x2 or Z were-2.498,-3.680,150.295 and-2.570,all P＜0.05].(4) Multivariate logistic regression analysis revealed that preterm delivery,maternal BMI＜18.5 kg/m2 and girl baby were independent risk factors for LBW in singleton pregnancies (adjusted OR=28.45,1.59 and 1.45,95％CI:20.87-38.80,1.06-2.41 and 1.06-1.97,all P＜0.05).Preterm delivery,high E2 level at trigger (＞10 970 pmol/L) and different gender of twins were independent risk factors for LBW in dizygotic twin pregnancies (adjusted OR=4.51,1.35 and 1.45,95％CI:3.50-5.82,1.06-1.74 and 1.09-1.93,all P＜0.05).Conclusions High maternal serum E2 level after controlled ovarian stimulation (COS) in fresh embryo transfer cycle may be one of the risk factors for LBW in twin pregnancies.

Aim To study the effect of Macrophage colony-stimulating factor(M-CSF) on MMP-9 in RAW 264.7 cell and explore the relationship between atherosclerosis caused by M-CSF and the activity of MMP-9. Methods Gelatin zymography analysis was used to investigate the effect of M-CSF and PD98059 on the activity of MMP-9 in cultured RAW 264.7 cell.Western blot was used to study the effect of M-CSF and PD98059 on the express of p-ERK1/2 in cultured RAW 264.7 cell. Results The enzyme activity of MMP-9 was significantly increased after 24-hour M-CSF treatment.Meanwhile, M-CSF upregulated the expression of p-ERK1/2. Pre-treatment with PD98059 blocked partly the increased expression of p-ERK1/2 and the activity of MMP-9 induced by M-CSF. Conclusion M-CSF can induce the secretion of MMP9 in RAW 264.7 cell, which may be mediated by the phosphorylation of ERK1/2.