Objective This study aims to investigate the feasibility and safety of Da Vinci robotic-assisted thoracoscopy for resecting mediastinal tumors in pediatric patients.Methods From November 2020 to June 2023,a total of 80 pediatric patients undergoing mediastinal tumor resection at Wuhan Children's Hospital were randomly assigned into two groups,with each group consisting of 40 participants.The control group underwent conventional thoracoscopy,while the observation group underwent Da Vinci robotic-assisted thoracoscopy.This study aimed to compare perioperative indicators between the two groups and establish learning curves based on surgical duration and intraoperative blood loss.Additionally,it assessed levels of pain mediators and stress response markers before surgery and at 24 hours post-surgery,as well as postoperative complications.Inflammatory marker levels were evaluated one month after surgery,and the children's quality of life was measured using the Pediatric Quality of Life Inventory(PedsQL)Generic Core Scales before surgery and one month post-surgery.Results The surgical duration for the observation group and the control group was(1.76±0.33)hours and(2.82±0.62)hours,respectively,and the intraoperative blood loss was(49.83±6.39)mL and(71.55±8.19)mL,respectively.Furthermore,the post-operative drainage time,drainage volume,and hospital stay for the observation group were all lower than those for the control group(P<0.05).After surgery,the levels of BK,5-HT,NPY,and PGE2 in the observation group were(8.06±1.06)mg/L,(170.20±13.21)ng/L,(201.82±13.52)mg/L,and(241.82±15.32)ng/L,respectively,indicating lower levels of pain mediators,stress response markers,and inflammatory factors compared to the control group(P<0.05).he overall incidence of complications was 2.50%in the observation group as opposed to 20.00%in the control group.Moreover,there was a statistically significant improvement in quality of life after surgery within the observation group when compared to that within the control group(P<0.05).Conclusion Da Vinci robotic-assisted thoracoscopy demonstrates enhanced feasibility and safety in pediatric mediastinal tumor resection,thereby justifying its clinical promotion.

Objective:To conjecture the correlation between fetal hydrothorax(FHT)and pregnancy outcome through the analysis of 95 fetuses with hydrothorax and their mothers.Methods:In this case series study, 95 FHT patients admitted to the Third Affiliated Hospital of Zhengzhou University from January 2016 to October 2022 were retrospectively analyzed.According to the pregnancy outcome, these patients were divided into the induced labor group (13 patients) and the delivery group (82 patients). General data and genetic examinations of patients in the induced labor group were analyzed to explore their pathogenesis and genetics.According to the neonatal Apgar score, patients in the delivery group were divided into the normal group and the asphyxia group.Fifteen indicators including the maternal age, gestational week at first diagnosis, maternal complications, FHT location, FHT severity, FHT outcome during pregnancy, fetal ascites, hydrops fetalis, other abnormal fetal structures, amniotic fluid volume, intrauterine treatment, gestational week of delivery, mode of delivery, sex of the newborn, and newborn birth weight in the 2 groups were comparatively analyzed by the chi-square test.With the neonatal Apgar score as the dependent variable, variables that had statistical significance during the univariate analysis were included in the regression analysis, and a multivariate binary Logistic regression equation was established to explore the factors affecting the pregnancy outcome.Results:There were significant differences in the FHT outcome during pregnancy (16/22/13 cases vs.2/18/11 cases, χ2=6.994, P=0.030), FHT severity (27/24 cases vs.9/22 cases, χ2=4.475, P=0.034), hydrops fetalis (14/37 cases vs.23/8 cases, χ2=17.012, P=0.001), amniotic fluid volume (21/30 cases vs.24/7 cases, χ2=10.228, P=0.001), intrauterine treatment (19/32 cases vs.2/29 cases, χ2=9.603, P=0.002), gestational week of delivery[(38.15±2.05) weeks vs.(34.83±3.14) weeks, t=5.748, P=0.001], and newborn birth weight[(3 325.00±637.41) g vs.(2 714.58±837.99) g, t=3.727, P=0.001]between the normal and asphyxia groups(all P<0.05). Among them, hydrops fetalis ( OR=7.070, P=0.020) and severe FHT ( OR=6.927, P=0.043) were risk factors for neonatal Apgar scores.Intrauterine treatment ( OR=0.062, P=0.027) and gestational week of delivery( OR=0.577, P=0.022) could be used as a protective factor for neonatal Apgar scores. Conclusions:Diagnosis of FHT during the early gestational weeks and multiple fetal structural abnormalities, especially hydrops fetalis, have higher probabilities of abnormal genetic examinations, and the fetal prognosis was poor.It is recommended to carry out chromosomal karyo type and microarray tests, as well as whole exome sequencing and detection of genetic syndromes(if necessary), to avoid unnecessary fetal treatment and improve the survival rate of perinatal infants after intrauterine treatment.The poor prognosis is related to hydrops fetalis and severe FHT; however, timely intrauterine treatment and prolonging pregnancy can improve the pregnancy outcome and increase the survival rate of perinatal infants.

Objective:To study the clinical characteristics and risk factors of necrotizing enterocolitis (NEC) in one of the premature twins.Methods:A retrospective study was conducted on twin premature infants who were admitted to the Department of Neonatology at the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2022 and only one got NEC. The twins were divided into NEC group and control group, the clinical data were collected and analyzed by SPSS 26.0 statistical software.Results:This study enrolled 109 pairs of premature twins, 109 cases in the NEC group, and 109 cases in the control group. Univariate analysis showed that birth weight, pre NEC white blood cell count were lower in NEC group than those in the control group, while the proportion of smaller than gestational age (SGA), donor of twin-to-twin transfusion syndrome, feeding intolerance, incomplete enteral feeding, start feeding time >48 h, red blood cell transfusion 72 h before NEC onset and the neutrophils ratio were higher in the NEC group than that of the control group, the difference was statistically significant ( P<0.05). Multivariate logistic analysis showed that low birth weight ( OR=1.558, 95% CI1.197-2.142), SGA ( OR=1.721, 95% CI 1.217-2.536), feeding intolerance ( OR=3.798, 95% CI 1.347-10.706), and incomplete enteral feeding ( OR=4.319, 95% CI 1.673-11.149) were independent risk factors for NEC ( P<0.05). Conclusions:Low birth weight, small for gestational age, feeding intolerance, and incomplete enteral feeding are independent risk factors for NEC in one of the premature twins.

Objective:To investigate the diagnostic value and imaging characteristics of MRI combined with 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/CT in focal cortical dysplasia (FCD) complicated with refractory epilepsy. Methods:A retrospective analysis was performed on 42 patients with FCD complicated with refractory epilepsy who were admitted to the Affiliated Hospital of Jining Medical University from January 2017 to December 2022. All patients underwent preoperative MRI and 18F-FDG PET/CT, and PET/MRI fusion was performed on the images. Chi-square test and Kappa consistency test were used to compare the localization diagnostic efficacy of PET/CT, MRI and PET/MRI fusion for epileptic foci. The patients were categorized based on gender, lesion location, pathological type, seizure type, and efficacy. Independent sample t-test and analysis of variance were used to compare maximum standardized uptake (SUVmax) values and asymmetry index (AI) of the patients between different groups. Results:Among the 42 patients, the positive rates of MRI, PET/CT, PET/MRI fusion examinations were 85.7%(36/42), 95.2%(40/42), 100.0%(42/42), the lateral localization rates were 71.4%(30/42), 92.9%(39/42), 95.2%(40/42), and the localization rates were 57.1%(24/42), 81.0%(34/42), 88.1%(37/42), respectively. There were significant differences in the lateral localization rates and localization rates of epileptogenic foci between MRI and PET/CT (χ 2=6.574, P=0.010; χ 2=5.570, P=0.018). There were significant differences in the positive rates of lesions, the lateral localization rates and the localization rates of epileptogenic foci between MRI and PET/MRI fusion (χ 2=6.385, P=0.012; χ 2=8.571, P=0.003; χ 2=10.118, P=0.001). There were no significant differences in the positive rates of lesions between MRI and PET/CT, and in the positive rates of lesions, the lateral localization rates and localization rates of epileptogenic foci between PET/CT and PET/MRI fusion (χ 2=2.184, P=0.139; χ 2=2.024, P=0.155; χ 2=0.210, P=0.647; χ 2=0.819, P=0.365). The Kappa consistency test of PET/CT and PET/MRI fusion imaging was performed for the location of epileptogenic foci, and the Kappa=0.721 was obtained, indicating that they were consistent in the location of epileptogenic foci. The SUVmax values of patients with temporal lobe epilepsy were lower, and the AI values were higher than that of patients with extra temporal lobe epilepsy (7.4±1.3 vs 9.6±1.6, 15.5±2.6 vs 12.9±2.4; t=5.154, 6.083; P=0.001, 0.001). The SUVmax values of patients with good efficacy (according to the Engel efficacy grading system, grades Ⅰ-Ⅱ indicating good efficacy) were higher, and the AI values were lower than that of patients with poor efficacy (according to the Engel efficacy grading system, grades Ⅲ-Ⅳ indicating poor efficacy; 9.5±1.9 vs 7.9±2.1, 13.5±3.3 vs 14.8±3.0; t=2.789, 3.722; P=0.042, 0.029). There were no significant differences in SUVmax and AI values among different genders, pathological types and seizure types (all P>0.05). Conclusions:The imaging characteristics of patients with different types of FCD complicated with refractory epilepsy are different. PET/MRI fusion is better than MRI in the diagnosis of FCD complicated with refractory epilepsy, and is consistent with PET/CT in the location of epileptogenic foci.

ObjectiveTo investigate the condom use of men who have sex with men （MSM） in Shanghai， the information motivation behavioral skills model （IMB） theory was used to introduce psychosocial factors and study the relevant factors of consistent condom use （CCU） in this population. MethodsA cross-sectional study of 547 MSM in four districts of Shanghai was conducted by snowball sampling. The structural equation model based on psychosocial optimization was constructed and validated using the data collected by structured questionnaires. ResultsAmong the 547 respondents， the proportion of CCU in the past six months was 45.5%. Comparing the fitness of the initial model with that of the adjusted model， we found that the fitness of the adjusted model was good. ConclusionThe proportion of CCU among MSM in Shanghai is relatively low； In addition， information and motivation do not directly affect the CCU of this population； Only behavioral skills have a direct effect on CCU. Finally， social psychological measures should be emphasized for this population， and comprehensive and multi-level strategies should be formulated to control the spread of HIV in this population.

Objective: : Angiolipomas are usually found in the subcutaneous tissue of the trunk and limbs. Spinal angiolipomas (SALs) are uncommon and have rarely been reported. We report a series of nine SALs patients who received surgical treatment in our department. To summarize the clinical characteristics of SALs, propose our surgical strategies, and evaluate the effects of the operation. Methods: : This was a retrospective review of nine SALs patients who received surgical treatment from August 2015 to March 2020. Total or subtotal resection was determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. The outcomes were assessed based on the modified Japanese Orthopaedic Association (mJOA) scoring system utilized before surgery and at various follow-up points. Results: : Among the nine patients, the mean mJOA score before surgery was 6.6±2.3, compared with 10.1±1.1 at the last follow-up time point (33.4±11.8 months). All patients achieved good outcomes, even in cases of subtotal resection. Conclusion : Early surgical resection of SALs is recommended, and the specific procedures should be determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. Most of the patients had a good prognosis, even in cases of subtotal resection.

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and changes in bowel habits. IBS is a multifactorial, stress-sensitive disease. Epigenetic changes include DNA methylation change, histone modification, and differential expressions of microRNA and long non-coding RNA. Explaining the changes in IBS from the perspective of epigenetics could bring new insights for the pathogenesis and treatment of the disease. This article reviewed the progress in research on the epigenetics of IBS.

Antigenic purity is important for quality control of the foot-and-mouth (FMD) whole virus inactivated vaccine. The recommended method for evaluation the antigenic purity of FMD vaccine is to check the serum conversion to non-structural protein (NSP) 3AB antibody after 2 to 3 times inoculation of animals with inactivated vaccine. In this study, we developed a quantitative ELISA to detect the amount of residual 3AB in vaccine antigen, to provide a reference to evaluate the antigenic purity of FMD vaccine. Monoclonal antibody (Mab) of NSP 3A and HRP-conjugated Mab of NSP 3B were used to establish a sandwich ELISA to quantify the NSP 3AB in vaccine antigen of FMD. Purified NSP 3AB expressed in Escherichia coli was serially diluted and detected to draw the standard curve. The detectable limit was determined to be the lowest concentration of standard where the ratio of its OD value to OD blank well was not less than 2.0. Results: The OD value was linearly corelated with the concentration of 3AB protein within the range between 4.7 and 600 ng/mL. The correlation coefficient R² is greater than 0.99, and the lowest detectable limit is 4.7 ng/mL. The amount of 3AB protein in non-purified inactivated virus antigen was detected between 9.3 and 200 ng/mL depending on the 12 different virus strains, whereas the amount of 3AB in purified virus antigen was below the lowest detectable limit. The amount of 3AB in 9 batches of commercial FMD vaccine antigens was between 9.0 and 74 ng/mL, whereas it was below the detectable limit in other 24 batches of commercial vaccine antigens. Conclusion: the sandwich ELISA established in this study is specific and sensitive to detect the content of 3AB protein in vaccine antigen of FMD, which will be a useful method for evaluation of the antigenic purity and quality control of FMD inactivated vaccine.
Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Foot-and-Mouth Disease/prevention & control* ; Foot-and-Mouth Disease Virus ; Viral Nonstructural Proteins/genetics* ; Viral Vaccines

Objective:To investigate the mortality and causes of death in neonates from different medical institutions in Henan province.Methods:A retrospective analysis was performed on the death cases of 62 different medical institutions in 18 cities of Henan province in 2018, in order to compare the differences of neonatal mortality, age of death and the causes of death between maternal and child health care hospitals and general hospitals.Results:(1) A total of 80 780 newborns were admitted to 62 hospitals and 311 neonates died with a mortality rate of 3.85‰.A total of 33 339 newborns were admitted to 24 maternal and child health care hospitals, and 102 neonates died with a mortality rate of 3.06‰.Among them, 54 cases(52.9%) were premature infants and 48 cases(47.1%)were full-term infants.A total of 47 441 newborns were admitted to 38 general hospitals, and 209 neonates died with a mortality rate of 4.41‰.Among them, 111 cases(53.1%) were premature infants and 98 cases (46.9%) were full-term infants.Neonatal mortality in general hospitals was higher than that in maternal and child health care hospitals( P<0.05). (2) Neonatal death mainly occurred within one week after birth, especially within the first day.There were 67 cases of death(65.7%) in 24 maternal and child health care hospitals within the first day, including 34 cases (50.7%) of full-term infants and 33 cases (49.3%)of premature infants.And there were 87 cases of death(41.6%) in 38 general hospitals within the first day, including 50 cases (57.5%) of premature infants and 37 cases (42.5%) of full-term infants.Neonatal mortality within the first day after birth in maternal and child health care hospitals was higher than that in general hospitals( P<0.05). (3) The leading causes of neonatal death were non-infectious pulmonary diseases(128 cases, 41.2%), followed by birth asphyxia(73 cases, 23.5%) and infection(51 cases, 16.4%), but the causes of death in sequence varies from maternal and child health care hospitals and general hospitals.(4) For early death (within one week after birth) in both general hospitals and maternal and child health care hospitals, the main causes were birth asphyxia for full-term neonates, and pulmonary diseases(mainly respiratory distress syndrome)and birth asphyxia for premature infants.For late-stage death (2-4 weeks after birth) of neonates, infection was the leading cause in both term and preterm infants in general hospitals.For maternal and child health hospitals, the main causes of death for full-term infants were infection, and pulmonary diseases (mainly pulmonary hemorrhage and respiratory distress syndrome) for premature infants. Conclusion:There are some differences between maternal and child health care hospitals and general hospitals in neonatal mortality, mortality within the first day after birth, and causes of death.Therefore, it is necessary to strengthen the corresponding software and hardware constructions for newborns in different medical institutions to further reduce the neonatal mortality rate.

The main lysosomal protease cathepsin D (cathD) is essential for maintaining tissue homeostasis via its degradative function, and its loss leads to ceroid accumulation in the mammalian nervous system, which results in progressive neurodegeneration. Increasing evidence implies non-proteolytic roles of cathD in regulating various biological processes such as apoptosis, cell proliferation, and migration. Along these lines, we here showed that cathD is required for modulating dendritic architecture in the nervous system independent of its traditional degradative function. Upon cathD depletion, class I and class III arborization (da) neurons in Drosophila larvae exhibited aberrant dendritic morphology, including over-branching, aberrant turning, and elongation defects. Re-introduction of wild-type cathD or its proteolytically-inactive mutant dramatically abolished these morphological defects. Moreover, cathD knockdown also led to dendritic defects in the adult mushroom bodies, suggesting that cathD-mediated processes are required in both the peripheral and central nervous systems. Taken together, our results demonstrate a critical role of cathD in shaping dendritic architecture independent of its proteolytic function.