Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To understand the clinical characteristics of patients with Streptococcus anginosus group(SAG)pulmonary abscess and resistance of SAG.Methods 67 patients with pulmonary abscess admitted to a hos-pital from January 2018 to May 2022 were retrospectively analyzed,clinical data of patients with SAG pulmonary abscess were analyzed,and the minimum inhibitory concentration of antimicrobial agents to 18 SAG strains was de-tected by microbroth dilution method,the carriage of resistance genes and virulence genes of SAG were detected by high-throughput sequencing technology.Results Among 67 patients with pulmonary abscess,SAG accounted for 29.9％(20/67),out of which 2 were excluded due to bacterial inactivation,and 18 patients were included for fur-ther studies.18 patients with SAG pulmonary abscess were all community acquired,with an average age of(60.9±9.1)years.There were 13(72.2％)male patients,most patients(94.4％)complicated chronic pulmonary disease,with cough(94.4％)and expectoration(88.9％)as the initial symptoms,some patients(44.4％)had chest pain,and more than half(61.1％)didn't have fever.The proportion of neutrophils,erythrocyte sedimentation rate,and C-reactive protein were mostly elevated,while procalcitonin was normal.The resistance rate of 18 SAG strains to erythromycin,clindamycin,and tetracycline was＞65％,out of which 14 strains carried resistance gene ermB,13 strains carried resistance gene tetM,and 1 strain carried both resistance gene msrD and mefA.18 SAG strains were detected virulence gene psaA,out of which 3 strains were detected virulence gene nan A.Conclusion SAG is an im-portant pathogen that causes pulmonary abscess,and the patients'complications are mainly chronic pulmonary di-seases,with non-specific clinical manifestations;Most strains carry ermB and tetM genes,mediating resistance to macrolides,lincosamides,and tetracyclines.

Objective:To explore the predictive value of electrocardiogram repolarization related parameters combined with serum brain natriuretic peptide(BNP)and 25 hydroxyvitamin D3[25-(OH)-D3]for malignant arrhythmia(MA)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction.Methods:This study was a prospective single-center study,120 patients with acute myocardial infarction who underwent PCI in our hospital from June 2022 to June 2024 were selected,they were divided into combined group(n=25)and non combined group(n=95)based on whether MA occurred within 72 h after PCI.All patients underwent routine electrocardiogram examination,the mean R wave to R wave(RR)interval,QRS start to T end(QT)interval,T wave time,corrected QT(QTc)interval,T wave peak to T wave end(Tp-e)interval,T wave amplitude,and other electrocardiogram repolarization related parameters between two groups were measuredand compared.The serum BNP and 25-(OH)-D3 levels between two groups were detected and compared.Influencing factors were analyzed by single and multiple logistic regression analysis.Predict value was analyzed by receiver operating characteristic(ROC)curve.Results:The mean QT interval and QTc interval in the combined group were significantly lower than those in the non combined group(P＜0.05).The serum BNP levels in the combined group was significantly higher than that in the non combined group,and the serum 25-(OH)-D3 level was significantly lower than that in the non combined group(both P＜0.05).Univariate analysis showed that there were statistically significant differences in terms of age,number of vascular lesions,cardiac troponin I(cTnI),and creatine kinase MB(CK-MB)(P＜0.05).Multiple logistic regression analysis showed that serum CK-MB and BNP were independent risk factors for MA after PCI in patients with acute myocardial infarction,while mean QT interval,mean QTc interval,and elevated 25-(OH)-D3 were independent protective factors(P＜0.05).Draw ROC curves,and the results show that the mean QT interval,mean QTc interval,serum BNP,and 25-(OH)-D3 levels alone predict the area under curve(AUC)for postoperative MA after PCI was 0.762(0.706-0.817),0.822(0.772-0.871),0.809(0.757-0.862),and 0.709(0.642-0.775),respectively,the AUC for combined prediction was 0.882(0.843-0.920).Conclusion:Electrocardiogram repolarization related parameters such as mean QT interval and QTc interval for MA after PCI in patients with acute myocardial infarction were lower,serum BNP is increased,and 25-(OH)-D3 is decreased,the combined detection of these indicators has high predictive value for postoperative MA after PCI.

Objective:To explore the predictive value of electrocardiogram repolarization related parameters combined with serum brain natriuretic peptide(BNP)and 25 hydroxyvitamin D3[25-(OH)-D3]for malignant arrhythmia(MA)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction.Methods:This study was a prospective single-center study,120 patients with acute myocardial infarction who underwent PCI in our hospital from June 2022 to June 2024 were selected,they were divided into combined group(n=25)and non combined group(n=95)based on whether MA occurred within 72 h after PCI.All patients underwent routine electrocardiogram examination,the mean R wave to R wave(RR)interval,QRS start to T end(QT)interval,T wave time,corrected QT(QTc)interval,T wave peak to T wave end(Tp-e)interval,T wave amplitude,and other electrocardiogram repolarization related parameters between two groups were measuredand compared.The serum BNP and 25-(OH)-D3 levels between two groups were detected and compared.Influencing factors were analyzed by single and multiple logistic regression analysis.Predict value was analyzed by receiver operating characteristic(ROC)curve.Results:The mean QT interval and QTc interval in the combined group were significantly lower than those in the non combined group(P＜0.05).The serum BNP levels in the combined group was significantly higher than that in the non combined group,and the serum 25-(OH)-D3 level was significantly lower than that in the non combined group(both P＜0.05).Univariate analysis showed that there were statistically significant differences in terms of age,number of vascular lesions,cardiac troponin I(cTnI),and creatine kinase MB(CK-MB)(P＜0.05).Multiple logistic regression analysis showed that serum CK-MB and BNP were independent risk factors for MA after PCI in patients with acute myocardial infarction,while mean QT interval,mean QTc interval,and elevated 25-(OH)-D3 were independent protective factors(P＜0.05).Draw ROC curves,and the results show that the mean QT interval,mean QTc interval,serum BNP,and 25-(OH)-D3 levels alone predict the area under curve(AUC)for postoperative MA after PCI was 0.762(0.706-0.817),0.822(0.772-0.871),0.809(0.757-0.862),and 0.709(0.642-0.775),respectively,the AUC for combined prediction was 0.882(0.843-0.920).Conclusion:Electrocardiogram repolarization related parameters such as mean QT interval and QTc interval for MA after PCI in patients with acute myocardial infarction were lower,serum BNP is increased,and 25-(OH)-D3 is decreased,the combined detection of these indicators has high predictive value for postoperative MA after PCI.

Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

Aim To explore the MST1 knockdown at-tenuates the inhibitory effect of salvianolic acid B(Sal B)on pERK anti-renal fibrosis.Methods In vitro experiments stimulated human renal cortical proximal tubular epithelial cells(HK-2)with XMU-XP-1(10μmol·L-1)inhibitor;in vivo experiments induced wild-type(WT)and MST1 systemic knockout mouse(MST1-/-)renal fibrosis models with DEN/CCl4/C2H5OH(DCC)and interfered with Sal B(15 mg·kg-1·d-1,ig)intervention.Renal histopathology was observed by HE and Masson staining;α-SMA and pERK protein expression was detected by Western blot;and pERK protein expression was detected by im-munofluorescence.Results In vitro results showed that Sal B could inhibit pERK protein expression.In vivo results showed that Sal B could improve DCC-in-duced renal tissue pathological injury and inhibit α-SMA and pERK protein expression;MST1-/-aggrava-ted pathological injury and significantly up-regulated α-SMA and pERK protein expression.Conclusion Sal B reduces the stimulatory effect of XMU-MP-1 on HK-2 cells by inhibiting the phosphorylation of ERK protein;Sal B exerts its anti-renal fibrosis effect by inhibiting the phosphorylation of α-SMA protein and ERK pro-tein;and MST1-/-,aggravating the pathological inju-ry of renal tissue,significantly up-regulated the expres-sion of α-SMA and pERK protein,which in turn atten-uated the antirenal fibrosis effect of Sal B.

Objective To evaluate the pharmacokinetics(PK)and pharmacodynamics(PD)of propofol injectable emulsion,and to assess the bioequivalence of test and reference formulations in healthy Chinese adult volunteers.Methods Thirty-two healthy Chinese adult volunteers were recruited and randomly assigned to a fasting.single-dose,two-period and double-crossover study.Propofol was given to eligible subjects at a speed of 30 μg·kg-1·min-1 for 30 min.The concentration of propofol in plasma was determined by avalidated high performance liquid chromatography-tandem mass spectrometery(HPLC-MS/MS)method.The PK parameters of the two preparations were calculated.Bispectral index(BIS)was measured to calculate the PD parameters of two formulations.Adverse events during the trial were recorded.Results Thirty-one volunteers were included in the pharmacokinetic parameter set.The mean values of PK parameters of test andreference formulations were as follows:Cmax were(660.87±110.25)and(683.13±125.75)ng·mL-1;AUC0-t were(473.50±86.03)and(478.40±80.25)h·ng·mL-1;AUC0-∞ were(500.45±96.49)and(507.84±88.00)h·ng·mL-1;tmax were 0.47(0.25,0.53)and 0.50(0.40,0.54)h;t1/2 were(2.97±1.74)and(3.08±1.82)h.Thirty-one volunteers were included in the bioequivalence set.The 90％confidence intervals(CI)for the geometric mean ratios of Cmax,AUC0-t,AUC0-∞ were 92.64％-101.39％,96.43％-101.00％,95.67％-100.70％,respectively.The mean values of PD parameters of test and reference formulations were as follows:BISmin were(75.94±13.66)and(74.39±12.32);BISAUC0-60minwere 5 569.85±182.78 and 5 575.68±166.19;T-BISmin were 23.00 and 29.00 min,respectively.There were no serious adverse events.Conclusion Two formulations of propofol injectable emulsion were bioequivalent and both of them exhibited good safety.

Aim To explore the MST1 knockdown at-tenuates the inhibitory effect of salvianolic acid B(Sal B)on pERK anti-renal fibrosis.Methods In vitro experiments stimulated human renal cortical proximal tubular epithelial cells(HK-2)with XMU-XP-1(10μmol·L-1)inhibitor;in vivo experiments induced wild-type(WT)and MST1 systemic knockout mouse(MST1-/-)renal fibrosis models with DEN/CCl4/C2H5OH(DCC)and interfered with Sal B(15 mg·kg-1·d-1,ig)intervention.Renal histopathology was observed by HE and Masson staining;α-SMA and pERK protein expression was detected by Western blot;and pERK protein expression was detected by im-munofluorescence.Results In vitro results showed that Sal B could inhibit pERK protein expression.In vivo results showed that Sal B could improve DCC-in-duced renal tissue pathological injury and inhibit α-SMA and pERK protein expression;MST1-/-aggrava-ted pathological injury and significantly up-regulated α-SMA and pERK protein expression.Conclusion Sal B reduces the stimulatory effect of XMU-MP-1 on HK-2 cells by inhibiting the phosphorylation of ERK protein;Sal B exerts its anti-renal fibrosis effect by inhibiting the phosphorylation of α-SMA protein and ERK pro-tein;and MST1-/-,aggravating the pathological inju-ry of renal tissue,significantly up-regulated the expres-sion of α-SMA and pERK protein,which in turn atten-uated the antirenal fibrosis effect of Sal B.