To summarize the perioperative nursing experience of a patient with thoracic and abdominal aortic dissection aneurysm after Stanford type A aortic dissection surgery,who underwent intra-abdominal aortic aneurysm endovascular isolation,in situ fenestration branch covered stent placement,and artificial blood vessel bypass.The nursing points include regular evaluation of the intra-abdominal pressure of the patient,being on guard against the rupture of the dissection;specialist nurses participated in the preoperative multidisciplinary discussion;establishing an emergency plan for the rescue of ruptured aortic dissection;monitoring the vital signs of patients closely to prevent critical complications during surgery.After multidisciplinary treatment and meticulous care,the patient's surgery went smoothly and the postoperative recovery was good.The patient was discharged 8 days later.

To summarize the perioperative nursing experience of a patient with thoracic and abdominal aortic dissection aneurysm after Stanford type A aortic dissection surgery,who underwent intra-abdominal aortic aneurysm endovascular isolation,in situ fenestration branch covered stent placement,and artificial blood vessel bypass.The nursing points include regular evaluation of the intra-abdominal pressure of the patient,being on guard against the rupture of the dissection;specialist nurses participated in the preoperative multidisciplinary discussion;establishing an emergency plan for the rescue of ruptured aortic dissection;monitoring the vital signs of patients closely to prevent critical complications during surgery.After multidisciplinary treatment and meticulous care,the patient's surgery went smoothly and the postoperative recovery was good.The patient was discharged 8 days later.

The new-generation non-invasive prenatal screening technology (NIPT2.0) is a new method successfully realized in recent years based on high-throughput sequencing to synchronously and accurately detect fetal chromosomal aneuploidies, microdeletion/microduplication syndromes and dominantly inherited monogenic disorders. NIPT2.0 can circumvent the shortcomings of previous non-invasive prenatal screening techniques (NIPT and NIPT Plus) including incapability to detect fetal monogenic disorders, insufficient accuracy of detection and low positive predictive values for certain chromosomal abnormalities (in particular trisomy 13, sex chromosomal abnormalities, and small-segment microdeletions and microduplication syndromes). How to apply NIPT2.0 reasonably and normatively to maximize its clinical value has become an issue which requires clarification. The Reproductive Health Branch of the Chinese Maternal and Child Health Care Association has organized experts to fully discuss and jointly drafted this consensus, which has put forwards suggestions over the clinical application strategy for NIPT2.0, including the scope of application, target disease, pre-test consultation, clinical application pathway, post-test genetic counseling and intervention, quality control and limitations, for the reference by peers, with a view to standardize its application and provide better clinical service.

A refractory Crohn's disease patient with recurrent perianal fistulas failed to overcome the secondary loss of response to infliximab(IFX)after therapeutic drug monitoring,intensified anti-TNF dosing and in combination with azathioprine.Throughout the treatment process,clinical pharmacists assisted physicians in analyzing the risk factors and causes for loss of response,providing evidence for an individualized treatment strategy,and monitoring the efficacy and safety of the treatment.According to the relevant guidelines and literature,ustekinumab was the preferred biological agent after anti-TNF failure in perianal fistulizing Crohn's disease(pfCD).At the 12-week follow-up,fecal calprotectin and C-reactive protein decreased markedly,and the patient achieved fistula healing.This case provides references for current management strategy and perspective in IFX secondary non-responders with refractory pfCD,especially those who have undergone optimization therapy.

Objective:To compare the perinatal mental health status of women conceived through assisted reproductive technology (ART) and women conceived naturally.Methods:In a prospective China National Birth Cohort study, 2 693 pregnant women were enrolled in the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, School of Medicine from March 2017 to March 2021. They were divided into ART group ( n=733) and natural conception (NC group, n=1 960) according to the mode of conception. Mental health was assessed in the first trimester (<14 weeks), the second trimester (22-26 weeks), and the third trimester (30-34 weeks) as well as 6 weeks after delivery. Antenatally, mental health status was assessed by using the Center for Epidemiologic Studies Depression Scale (CESD), Self-rating Anxiety Scale (SAS), and Perceived Stress Scale (PSS). Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression was used to analyze maternal mental health related factors. Results:Logistic regression results showed that women in the ART group were less likely to experience depressive symptoms compared with those in the NC group in the first trimester (a OR=0.81, 95% CI: 0.66-0.99), the second trimester (a OR=0.73, 95% CI: 0.60-0.90), the third trimester (a OR=0.82, 95% CI: 0.68-1.00) and 6 weeks after delivery (a OR=0.57, 95% CI: 0.43-0.75). Meanwhile, women in the ART group felt significantly less stress during pregnancy than women in the NC group (the first trimester, P<0.001; the second trimester, P<0.001; the third trimester, P=0.001). However, the difference in women's anxiety symptoms during pregnancy was not found to be significant between the two groups (all P>0.05). Conclusion:Women who conceived through ART have lower risks of perinatal mental health problems than those who conceived spontaneously.

Objective:To compare the perinatal mental health status of women conceived through assisted reproductive technology (ART) and women conceived naturally.Methods:In a prospective China National Birth Cohort study, 2 693 pregnant women were enrolled in the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, School of Medicine from March 2017 to March 2021. They were divided into ART group ( n=733) and natural conception (NC group, n=1 960) according to the mode of conception. Mental health was assessed in the first trimester (<14 weeks), the second trimester (22-26 weeks), and the third trimester (30-34 weeks) as well as 6 weeks after delivery. Antenatally, mental health status was assessed by using the Center for Epidemiologic Studies Depression Scale (CESD), Self-rating Anxiety Scale (SAS), and Perceived Stress Scale (PSS). Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression was used to analyze maternal mental health related factors. Results:Logistic regression results showed that women in the ART group were less likely to experience depressive symptoms compared with those in the NC group in the first trimester (a OR=0.81, 95% CI: 0.66-0.99), the second trimester (a OR=0.73, 95% CI: 0.60-0.90), the third trimester (a OR=0.82, 95% CI: 0.68-1.00) and 6 weeks after delivery (a OR=0.57, 95% CI: 0.43-0.75). Meanwhile, women in the ART group felt significantly less stress during pregnancy than women in the NC group (the first trimester, P<0.001; the second trimester, P<0.001; the third trimester, P=0.001). However, the difference in women's anxiety symptoms during pregnancy was not found to be significant between the two groups (all P>0.05). Conclusion:Women who conceived through ART have lower risks of perinatal mental health problems than those who conceived spontaneously.

OBJECTIVETo review the application of thoracoscopic repair for treatment of congenital diaphragmatic hernia in neonates, so as to improve the cure rate.

METHODSClinical data of 47 neonates with congenital diaphragmatic hernia receiving thoracoscopic repair from June 2012 to June 2017 were reviewed. The admission age, gestational age, birth weight, timing of diagnosis, hernia location, clinical manifestation, surgical timing, surgical method, operation time, postoperative mechanical ventilation time of patients were analyzed.

RESULTSThere were 42 cases of left diaphragmatic hernia and 5 cases of right diaphragmatic hernia. Thirteen cases were diagnosed prenatally. Primary diaphragmatic repair was successfully accomplished under thoracoscope in 45 neonates without perioperative complications, while 2 patients were converted to open surgery. The average operation time was (63±13) min (42-150 min), the average blood loss was (3.0±1.7) mL (1.0-9.0 mL), and the average postoperative mechanical ventilation time was (3.9±1.4) d (2.0-11.0 d). Two patients died and the treatment was withdrawn in 3 patients with an overall cure rate of 89.4% (42/47).

CONCLUSIONSThoracoscopic repair is effective and can be used as first-choice treatment of diaphragmatic hernia in neonates.

Objective To investigate the gene mutations of human immunodeficiency virus (HIV)‐1 drug resistance among anti‐retrovirus (ARV ) treated‐naive men who have sex with men (MSM ) in Shanghai to provide evidence‐based data for optimized treatment .Methods All 669 treatment‐nave cases of HIV‐1 infection identified among MSM in 2013 were recruited and their plasma was collected .RNA was extracted and amplified by nest reverse transcription‐polymerase chain reaction ,and DNA was sequenced and then phylogenetically analyzed .Finally ,subtypes were identified and drug resistance was analyzed in comparison with International HIV Drug Resistance Database .Results The pol gene fragments of 645 cases were obtained .Primary drug‐resistance rate was 2 .48% (16/645) ,including mutations conferring resistance to protease inhibitor (PI) (0 .31% ,2/645) ,nucleoside reverse transcriptase inhibitors (NRTI) (0 .16% ,1/645) ,non‐nucleoside reverse transcriptase inhibitors (NNRTI) (1 .70% ,11/645) and both NRTI and NNRTI (0 .31% ,2/645) ,respectively .Mutations conferring resistance to CRF01_AE were 12 cases (2 .99% ) ,while mutations conferring resistance to CRF07_BC and CRF_01B were 0 .61%(1/163) and 4 .65% (2/43 ) including 1 case of CRF52_01B and unidentified CRF_01B , respectively . Resistance to NNRTI in B subtype were 2 .70% (1/37) .Conclusion The prevalence of HIV‐1 drug resistance‐associated mutations among MSM in Shanghai ,2013 is still low ,but resistance to NNRTI is relatively high .CRF01_AE is the major subtype of drug resistance .It is necessary to strengthen the HIV drug resistance surveillance in MSM group in Shanghai .

Objective:To prepare the egg yolk immunoglobulin Y ( IgY) against human Sucrase and study its stability,in vitro activity. Methods:Hy-line laying hens were immunized with human Sucrase protein,IgY was isolated and purified from egg yolks of im-munized hens using water dilution and salting out method. Indirect ELISA was used to evaluate the titer and stability of IgY. The purity and specificity of IgY were analysed by SDS-PAGE and Western blot respectively. The inhibitory effects of IgY on α-glucosidase was studied by PNPG method. Results:Indirect ELISA results showed IgY could be detected on the tenth day after the first immunization, and the peak titer of IgY was 1:12 800 after the 40th day of immunization. SDS-PAGE showed that the heavy chain and light chain of IgY were 65 kD and 25 kD respectively, and the IgY against human Sucrase could specifically recognize the protein of human Sucrase. The IgY maintained primary titer when it was kept between 29-69℃ for 15 min,and pH 4-7,37℃,4 h. The titer of IgY was maintained 50% after digestion by pepsin and trypsin respectively for 2 hours. IgY had a higher resistence to pepsin than trypsin after longer digestion time. IgY showed an inhibitory effect on α-glucosidase in concentration dependent manner. The half inhibitory concentration (IC50) was 0. 540 mg/ml. Conclusion:The IgY against human Sucrase has been successfully obtained,which established foundations for its study of Type 2 diabetes mellitus rat models in vivo.

Reproduction, fat metabolism, and longevity are intertwined regulatory axes; recent studies in C. elegans have provided evidence that these processes are directly coupled. However, the mechanisms by which they are coupled and the reproductive signals modulating fat metabolism and lifespan are poorly understood. Here, we find that an oogenesis-enriched gene, c30f12.4, is specifically expressed and located in germ cells and early embryos; when the gene is knocked out, oogenesis is disrupted and brood size is decreased. In addition to the reproductive phenotype, we find that the loss of c30f12.4 alters fat metabolism, resulting in decreased fat storage and smaller lipid droplets. Meanwhile, c30f12.4 mutant worms display a shortened lifespan. Our results highlight an important role for c30f12.4 in regulating reproduction, fat homeostasis, and aging in C. elegans, which helps us to better understand the relationship between these processes.
Animals ; Caenorhabditis elegans ; genetics ; metabolism ; Caenorhabditis elegans Proteins ; genetics ; metabolism ; Female ; Lipid Droplets ; metabolism ; Lipid Metabolism ; physiology ; Longevity ; physiology ; Mutation ; Oogenesis ; physiology