Objective:To establish reference ranges of central nervous system-related fetal intracranial markers during the first trimester in a local population of Suzhou.Methods:Ultrasound images of fetuses with normal birth outcomes in singleton pregnancies who underwent nuchal translucency(NT) screening during the first trimester (11-13 + 6 gestational weeks) from January 2021 to July 2022 at the Affiliated Suzhou Hospital of Nanjing Medical University were retrospectively selected. The images including 3 planes: the midsagittal plane of the fetal head, also known as the plane for NT measurement, the trans-ventricular plane of the fetal head, and the axial plane of the fetal head at the posterior fossa level. The brainstem (BS) thickness, brainstem to occipital bone distance (BSOB), the ratio of BS to BSOB (BS/BSOB), intracranial translucency (IT) thickness, cisterna magna (CM) width, and the midbrain (MB) to falx (F) ratio MB/F were measured in the mid-sagittal plane of the fetal head. Choroid plexus length (CPL) to occipital frontal diameter (OFD) ratio CPL/OFD, and choroid plexus area (CPA) to head area (HA) ratio CPA/HA were measured in the trans-ventricular plane of the fetal head. Anteroposterior diameter of the fourth ventricle (4V) and CM were measured in the axial plane of the fetal head at the posterior fossa level.Statistical analysis was performed to obtain the corresponding normal reference range.Intra-class correlation coefficient (ICC) was used to analyze intra-observer and inter-observer consistency. Pearson correlation analysis and linear correlation analysis were used to study the correlations between crown-lump length (CRL) and intracranial markers, and the regression equation was derived. Results:A total of 2 331 fetuses were enrolled, providing 1 023 images of the midsagittal plane, 817 images of the trans-ventricular plane, and 567 images of the axial plane of the fetal head at the posterior fossa level. The intra-observer and inter-observer ICCs of intracranial markers BS, BSOB, BS/BSOB, IT thickness, CM width, MB/F in the mid-sagittal plane, the intracranial markers CPL/OFD, CPA/HA on the trans-ventricular plane, and the intracranial markers 4V and CM width in the axial plane at the posterior fossa level were all >0.75. Fetal intracranial markers were linearly correlated with CRL. The midsagittal plane: BS, BSOB, BS/BSOB, IT thickness, CM width, MB/F were linearly correlated with CRL ( r=0.508, 0.626, -0.234, 0.105, 0.508, -0.493; all P<0.05); the trans-ventricular plane: CPL/OFD, CPA/HA were linearly correlated with CRL( r=-0.324, -0.268; all P<0.001); the axial plane of the fetal head at the posterior fossa level: 4V, CM width were linearly correlated with CRL ( r=0.246, 0.467; all P<0.001). Conclusions:Quantitative analysis of fetal intracranial markers in the first trimester is feasible. This study constructed a normal reference range of multiple intracranial markers related to central nervous system in the first trimester with a local population of Suzhou. And the construction of this normal range can provide an objective basis for the detection of fetal central nervous system malformations in the first trimester.

Objective::To use fetal heart quantification ( fetal HQ) technology to compare the coarctation of the aorta (CoA) and normal fetal heart structure and systolic function and to assess whether there are abnormalities in the fetal heart structure and systolic function associated with CoA. Methods::This prospective cohort study was conducted from May 2020 to December 2022 and involved 18-40-week-old singleton pregnancies and 30 fetuses diagnosed with CoA using fetal echocardiography at the General Hospital of Ningxia Medical University and Peking University First Hospital Ningxia Women’s and Children’s Hospital, China. The control group contained 60 normal fetuses. The following parameters were recorded and analyzed statistically: four-chamber view (4CV) end-diastolic long diameter, 4CV epicardial-contralateral epicardial transverse maximum diameter, 4CV global sphericity index (GSI), left ventricular (LV) and right ventricular (RV) 24-segment end-diastolic diameter (EDD), 24-segment sphericity index (SI), LV-fractional area change (LV-FAC), LV-longitudinal strain (LV-LS), RV-fractional area change (RV-FAC), RV-longitudinal strain (RV-LS), and LV and RV 24-segment transverse fractional shortening (FS). Measurement data were compared between the two groups using an independent sample t test, with P < 0.05 indicating statistically significant differences. Moreover, the correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS was assessed. Results::Within and between observer comparisons of the parameters associated with major cardiac function revealed an intragroup correlation coefficient of >0.9, indicating high consistency, and a coefficient of variable of <1 %, indicating low variability. Correlation analysis revealed no obvious correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS. A comparison of the four-chamber morphological structural parameters of the hearts in the two groups revealed that when compared with the control group, the 4CV end-diastolic long diameter was shortened in fetuses in the CoA group and the epicardial-contralateral epicardial transverse maximum diameter was wider, while the GSI was lower ( P < 0.05). A comparison of the LV and RV morphological structure parameters between the two groups revealed that when compared with the control group, the LV’s 24-segment EDD was smaller in the CoA group, the RV’s 24-segment EDD was greater in the control group, the SI of the LV’s segments 16-24 was greater than in the control group, and the SI of the RV’s segments 7-24 was less than in the control group (all P < 0.05). When compared with fetuses in the control group, the LV’s segments 16-24 were greater in the CoA group, whereas the RV’s segment 6-24 was smaller ( P < 0.05). When compared with the control group, LV-FAC, RV-FAC, and LS were lower in the CoA group ( P < 0.05). The FS of the LV segments 1-24 and the FS of the RV segments 1-16 were smaller in the CoA group than in the normal group ( P < 0.05). Conclusion::Fetal HQ, a new simple technique that offers rapid analysis and high repeatability, can quantitatively evaluate structural and systolic function changes in fetuses with CoA.

Objective::To use fetal heart quantification ( fetal HQ) technology to compare the coarctation of the aorta (CoA) and normal fetal heart structure and systolic function and to assess whether there are abnormalities in the fetal heart structure and systolic function associated with CoA. Methods::This prospective cohort study was conducted from May 2020 to December 2022 and involved 18-40-week-old singleton pregnancies and 30 fetuses diagnosed with CoA using fetal echocardiography at the General Hospital of Ningxia Medical University and Peking University First Hospital Ningxia Women’s and Children’s Hospital, China. The control group contained 60 normal fetuses. The following parameters were recorded and analyzed statistically: four-chamber view (4CV) end-diastolic long diameter, 4CV epicardial-contralateral epicardial transverse maximum diameter, 4CV global sphericity index (GSI), left ventricular (LV) and right ventricular (RV) 24-segment end-diastolic diameter (EDD), 24-segment sphericity index (SI), LV-fractional area change (LV-FAC), LV-longitudinal strain (LV-LS), RV-fractional area change (RV-FAC), RV-longitudinal strain (RV-LS), and LV and RV 24-segment transverse fractional shortening (FS). Measurement data were compared between the two groups using an independent sample t test, with P < 0.05 indicating statistically significant differences. Moreover, the correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS was assessed. Results::Within and between observer comparisons of the parameters associated with major cardiac function revealed an intragroup correlation coefficient of >0.9, indicating high consistency, and a coefficient of variable of <1 %, indicating low variability. Correlation analysis revealed no obvious correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS. A comparison of the four-chamber morphological structural parameters of the hearts in the two groups revealed that when compared with the control group, the 4CV end-diastolic long diameter was shortened in fetuses in the CoA group and the epicardial-contralateral epicardial transverse maximum diameter was wider, while the GSI was lower ( P < 0.05). A comparison of the LV and RV morphological structure parameters between the two groups revealed that when compared with the control group, the LV’s 24-segment EDD was smaller in the CoA group, the RV’s 24-segment EDD was greater in the control group, the SI of the LV’s segments 16-24 was greater than in the control group, and the SI of the RV’s segments 7-24 was less than in the control group (all P < 0.05). When compared with fetuses in the control group, the LV’s segments 16-24 were greater in the CoA group, whereas the RV’s segment 6-24 was smaller ( P < 0.05). When compared with the control group, LV-FAC, RV-FAC, and LS were lower in the CoA group ( P < 0.05). The FS of the LV segments 1-24 and the FS of the RV segments 1-16 were smaller in the CoA group than in the normal group ( P < 0.05). Conclusion::Fetal HQ, a new simple technique that offers rapid analysis and high repeatability, can quantitatively evaluate structural and systolic function changes in fetuses with CoA.

ObjectiveThe transcriptome characteristics of different tissues of Codonopsis pilosula were analyzed to illustrate the genetic basis of the accumulation of active ingredients in the root of C. pilosula， and to provide theoretical basis for its high-quality production and cultivation. MethodDifferent tissues of C. pilosula at flowering stage were selected as experimental materials， and the contents of tangshenoside Ⅰ， lobetyolin and atractylenolide Ⅲ were detected by high performance liquid chromatography（HPLC）. RNA-Seq was used to perform transcriptome sequencing of different tissues， and the differentially expressed genes were screened and analyzed by Gene Ontology（GO） and Kyoto Gene and Encyclopedia of Genes and Genomes（KEGG） enrichment analysis， in order to explore the characteristics of active compound distribution and the transcriptional profiles. ResultThe contents of polysaccharides and tangshenoside Ⅰ in the root of C. pilosula were significantly higher than those in other tissues. The transcriptional profiles of the root were significantly different from those of stem， leaf and flower. Cluster analysis， GO and KEGG enrichment analysis of differential gene expression showed that the differential expression genes were mainly enriched in flavonoid and phenylpropanoid biosynthesis， sucrose-starch metabolism， plant hormone signal transduction， plant-pathogen interaction， mitogen-activated protein kinase（MAPK） cascade signal transduction， Adenosine triphosphate（ATP）-binding cassette（ABC） transporter and other pathways. The expression of genes related to biosynthesis of phenylpropanoid compounds were significantly up-regulated in the roots and flowers， and ABC transporter proteins were mostly highly expressed in the flowers. The expression of key enzyme genes for polysaccharide synthesis， such as sucrose：sucrose 1-fructosyltransferase（1-SST） and fructan 1-exohydrolase（1-Feh）， were significantly up-regulated in the roots， and a large number of stress-responsive genes closely related to the accumulation of secondary metabolites were significantly up-regulated in the roots. ConclusionThe active compound content and transcriptional profiles in C. pilosula roots were significantly different from those in stem， leaf， flower and other tissues， showing tissue specificity. Meanwhile， the genes related to stress response and biosynthesis of active compound， such as fructan and phenylpropanoid compounds， were up-regulated in roots of C. pilosula.

Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.

OBJECTIVE To screen the optimal compatibility ratio of Gentiana straminea Maxim.(G.S Maxim) and Rhodiola crenulata (Hook. f. et Thoms.) H. Ohba(R. crenulata), and explore its anti-hypoxia effect and possible mechanism through in vivo and in vitro experiments and network pharmacology. METHODS PC12 cells were divided into groups, and the cell hypoxia model was established by Na2S2O4, H2O2 and physical hypoxia methods, and the compatibility ratio of G.S Maxim-R. crenulata was initially screened. Eighty SPF male Kunming mice were randomly divided into blank group, model group, positive group, and different compatibility ratio groups of G.S Maxim-R. crenulata(2:8, 3:7, 4:6, 5:5, 6:4, 7:3, 8:2), with 8 mice in each group. Gastric drug delivery in 15 d in advance, in addition to the blank group, the rest of the groups were normal pressure hypoxia experiments. Groups of mice survival time was recorded. Detected the levels of inflammatory cytokines, MDA content, and SOD activity in the lung tissues of mice in the blank group, model group, positive group, G.S Maxim-R. crenulata 4:6 group and 3:7 group. The anti-hypoxia mechanism of G.S Maxim-R. crenulata was investigated by network pharmacology and molecular docking, and verified by qPCR. RESULTS In vitro experiments showed that G.S Maxim-R. crenulata had better anti-hypoxia activity. In vivo experimental results showed that the combination ratio of G.S Maxim-R. crenulata with 4:6 and 3:7 could significantly improve the survival time of mice, reduce the contents of NF-κB, IL-6, IL-1β and MDA in lung tissue, and increase the content of IL-10 and SOD activity, and the effect of G.S Maxim-R. crenulata 3:7 group was the best. Network pharmacological studies showed that the potential active components of G.S Maxim-R. crenulata in anti-hypoxia might be ursolic acid, oleanolic acid, and ethyl gallate, etc. The core targets included SRC, PIK3CA, MAPK3, etc., and its anti-hypoxia signaling pathways mainly included PI3K-Akt, HIF-1, etc. The results of qPCR showed that G.S Maxim-R. crenulata could increase the expression of PI3K, Akt, mTOR and p62 in the lung tissue of hypoxic mice. Molecular docking verification showed that the core targets SRC, PIK3CA, and p62 had good binding activity with potential active components such as oleanolic acid, kaempferol, ethyl gallate and quercetin. CONCLUSION G.S Maxim-R. crenulata has anti-hypoxia activity, which may be related to PI3K/Akt signaling pathway through anti-inflammatory, anti-oxidative stress and regulation of autophagy.

Objective:Rapid assessment of the outcome after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) is an important clinical issue. In this study, an electrocardiogram (ECG) analysis method based on dynamic learning was proposed.Methods:A total of 203 patients with ACS after successful PCI were enrolled for prospective analysis at the Emergency Department of Qilu Hospital of Shandong University from April 2019 to December 2020. All patients were divided into group without ≥70% postoperative stenosis ( n=72) and group with ≥ 70% postoperative stenosis ( n=131) according to the presence of 70% or more stenosis after PCI. The clinical data of ACS patients were collected and analyzed by χ2 test, t-test, or Mann-Whitney test. ECGs were recorded before and 2 h after PCI, and were dynamically analyzed to generate cardiodynamicsgram (CDG) using dynamic learning. In the group without ≥ 70% postoperative stenosis, the model and CDG index for evaluating myocardial ischemia were obtained by training support vector machine (SVM) using 10 times 10-fold cross-validation. Results:There was no significant difference in clinical data between the two groups. The prediction accuracy and sensitivity of the support vector machine model for myocardial ischemia in group without≥70% postoperative stenosis were 73.61%, and 84.72% respectively. CDG transformed from disorderly to regular after PCI, and CDG index decreased significantly ( P<0.001): 90.28% (65) patients in group without≥70% postoperative stenosis, and 79.39% (104) patients in group with≥70% postoperative stenosis had lower CDG indexes than before PCI. Conclusions:In this study, CDG obtained by dynamic learning can intuitively and effectively evaluate the changes of myocardial ischemia before and after PCI, which is helpful to assist clinicians to formulate the next treatment plan.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*

Objective: To describe the status of cognition about colorectal cancer and the screening and its relevant factors among first degree relatives of hereditary colorectal cancer patients in Guangzhou. Methods: Totally 274 subjects were investigated by a self-designed demographic questionnaire and the Chinese version of Cognitive Questionnaire for Colorectal Cancer and were analyzed by chisquare test, rank sum test and logistic regressive. Results: 60.2% (165/274) cases had a high level of cognition about colorectal cancer, 23.7% (65/274) had middle level of cognition about colorectal cancer and 16.0% (44/274) had a low level of cognition about colorectal cancer. Multivariate logistic regression analysis showed that age, sex, degree of education, marital status, family income, medical insurance and the number of cancer patients in his family were related factors (P<0.05). People who were young, female, highly educated, high family income, single, public/urban health insurance, commercial insurance and with more than 4 relatives suffering from colorectal cancer have higher cognitive level. Conclusions The level of cognition about colorectal cancer among first degree relatives of hereditary colorectal cancer patients was a little high. Medical staff should pay attention to relevant factors of health belief in subjects and develop targeted intervention to improve the level of cognition among these subjects and to promote their screening behavior.

Objective:To analyze the immunocontraceptive efficacy of CZP3 DNA vaccine by electric pulse stimulating and the correlation between antibody level and antifertility. Methods: The mice were immunized with 5, 10, 20 and 50 μg DNA vaccine pcDNA3. 0-CZP3 respectively and were stimulated at leg muscle by electric pulse. Detect the antibody level of each mice group and the highest antibody titer by ELISA. After mated with male mice for three weeks,calculated infertility rate of mice,the average litter size of each immune group and did statistical analysis. Results:Compared with the intramuscular injection alone,the electric pulse stimulation could increase serum antibody titers of mice significantly, the antibody titer of 50 μg group which was stimulated by electric pulse reached 1∶4 000. Moreover,the infertility of the mice increased and the mice average litter size reduced along with the increase of CZP3 antibody level significantly. Statistical analysis showed that the antibody level and the average litter size had a negative correlation. Conclusion:The electric pulse stimulation can improve the immune level and reduce the fertility efficiency of mice significantly,therefore establishes a foundation for further application of CZP3 DNA vaccine in stray dog contraception.