ObjectiveTo systematically analyze the epidemiological characteristics and cause-of-death distribution among death cases with hepatitis C in Hongkou District of Shanghai, and to provide a scientific basis for optimizing healthcare resources allocation and targeted hepatitis C prevention and control measures. MethodsA retrospective cross-sectional study was conducted by integrating historical surveillance data from China Information System of Disease Prevention and Control and Shanghai Hongkou District Death Medical Registration System. Data on demographic characteristics, hepatitis C-related clinical and management records, and underlying causes of death for cases with hepatitis C between 2012 and 2024 in Hongkou District of Shanghai, were collected. Descriptive analyses were performed to analyze the epidemiological characteristics and cause-of-death distribution of death cases, and comparative analyses were conducted across different subgroups. ResultsA total of 204 hepatitis C-related deaths were identified in Hongkou District, Shanghai, from 2012 to 2024. The average age at death was (69.49±12.75) years The majority decedents were males (71.57%) and retired (73.53%). The top three underlying causes of death were malignant tumors (45.10%), cerebrovascular diseases (15.20%) and cardiovascular diseases (12.25%), collectively accounting for 72.55% of all deaths. Deaths attributed to hepatitis C accounted for 9.80% (20/204), with a mean age at death of (63.41±11.81) years. No statistically significant differences were observed in the proportion of hepatitis C-attributed deaths across different subgroups (all P>0.05). The proportion of premature deaths was 55.88% (114/204), with a mean age at death of (60.02±6.89) years. The proportion of premature deaths was higher among males (60.27%), laboratory-diagnosed patients (62.69%), patients with other liver diseases (72.06%), and those non-compliant with follow-up (70.97%) compared to their respective counterparts (all P<0.05). Additionally, homemakers /unemployed patients (100.00%) and employed patients (88.89%) had a significantly higher proportion of premature deaths compared to retired patients (42.67%) (P<0.001). There was a statistically significant difference in the distribution of causes of death between the premature death group and the non-premature death group (χ²=14.93， P=0.048). The top three causes of premature deaths were malignant tumors (50.00%), hepatitis C (12.28%) and cerebrovascular diseases (10.53%). Regarding the proportion of deaths occuring prematurely, other viral hepatitis had the highest percentage (75.00%), followed by diabetes mellitus (71.43%) and hepatitis C (70.00%). ConclusionThe majority of death cases with hepatitis C were males and retirees in Hongkou District, Shanghai. The leading cause of death was malignant tumors, while hepatitis C ranked as the fourth underlying cause, as well as served as the second leading cause of premature death following malignant tumors. Premature death was closely associated with gender, occupation, diagnostic classification, presence of other liver diseases, and follow-up compliance, highlighting the importance of enhanced health management and targeted interventions among high-risk groups.

OBJECTIVE: To explore the prenatal ultrasonographic features and genetic basis for an abortus suspected for type II Cornelia de Lange syndrome (CdLS2). METHODS: A fetus diagnosed with CdLS2 at the Shengjing Hospital Affiliated to China Medical University on September 3, 2019 was selected as the study subject. Clinical data of the fetus and family history was collected. Following induced labor, whole exome sequencing was carried out on the abortus. Candidate variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: Prenatal ultrasonography (33 weeks of pregnancy) has revealed multiple anomalies in the fetus, which included slightly widened cavity of septum pellucidum, blurred corpus callosum, slightly reduced frontal lobe volume, thin cortex, fusion of lateral ventricles, polyhydramnios, small stomach bubble, and digestive tract atresia. Whole exome sequencing has revealed a heterozygous c.2076delA (p.Lys692Asnfs*27) frameshifting variant in the SMC1A gene, which was found in neither parent and was rated as pathogenic based on the guidelines of American College of Medical Genetics and Genomics (ACMG). CONCLUSION The CdLS2 in this fetus may be attributed to the c.2076delA variant of the SMC1A gene. Above finding has provided a basis for genetic counseling and assessment of reproductive risk for this family.
Pregnancy ; Female ; Humans ; Cell Cycle Proteins/genetics* ; De Lange Syndrome/diagnosis* ; Phenotype ; Ultrasonography, Prenatal ; Fetus/diagnostic imaging* ; Mutation

【Objective:】 To explore the network characteristics of sleep quality and anxiety in first-line medical staff fighting against COVID-19, further understand the relationship between sleep quality and anxiety, and provide basis for intervention. 【Methods:】 Using the convenient sampling method, this paper used the Pittsburgh Sleep Quality Index (PSQI) and Self Rating Anxiety Scale (SAS) to conduct a questionnaire survey on the front-line medical staff who fought against the epidemic during the COVID-19. Network analysis was used to construct sleep quality and anxiety network, and R language was used for statistical analysis and visualization. 【Results:】 In the network of sleep quality and anxiety of first-line medical staff fighting against COVID-19, "sleep disorder" and "sleep quality", "unfortunate premonition" and "inability to sit still", "syncope" and "hand and foot tingling" were highly related. "Fatigue", "dizziness" and "panic" had the highest expected influence. "Sleep quality", "sleep disorder" and "fatigue" had the highest bridge expected influence. The average predictability value of all nodes was 0.778. 【Conclusion:】 This paper used network analysis to explore the sleep quality and anxiety of first-line medical staff fighting against COVID-19 and found that there was a unique correlation path between them. Intervention against core symptoms can ameliorate anxiety and sleep problems to the great extent, and provide guidance for improving the physical and mental health.

Objective To investigate the value of hepatocyte growth factor ( HGF ) and transforming growth factor-β1 (TGF-β1) in the diagnosis of early stage non-small cell lung cancer (ES-NSCLC) through detection of their levels in serum and bronchoalveolar lavage fluid ( BALF ) . Methods Serum and BALF samples were collected from 48 cases of ES-NSCLC ( at stage 1 and 2 ) , 45 cases of medium and advanced NSCLC (at stage 3 and 4), 42 cases of benign pulmonary nodule and 30 controls for the study. The levels of HGF and TGF-β1 were respectively detected by ELISA, and their differences were analyzed between the 4 groups. The relationship between HGF and TGF-β1 levels and tumor size, differentiation and pathological type was further analyzed, and sensitivity and specificity in the diagnosis of ES-NSCLC was evaluated in the study. Results The levels of HGF and TGF-β1 in BALF of the ES-NSCLC group were significantly higher than those in the benign pulmonary nodule group and the normal control group (P <0. 05). HGF and TGF-β1 serum levels in the ES-NSCLC group were higher than those in the benign pulmonary nodule group and the control group, however, no statistical significance could be seen when comparisons were made between them ( P >0. 05). Serum HGF and TGF-β1 levels in the BALF of the medium and advanced NSCLC group were significantly higher than those in the ES-NSCLC group (P<0. 05). The areas under the curve (AUC) in the BALF of HGF and TGF-1 were respectively 0. 754 and 0. 839. When the levels of 59. 32pg/ml and 98. 52pg/ml were selected as the optimal cutoff values according to the Jordan index maximum method, the sensitivity of HGF and TGF-β1 in the diagnosis of ES-NSCLC were respectively 41. 7％ and 81. 3％, and specificity were respectively 96. 3％ and 77. 8％. Furthermore, in the patients with adenocarcinoma or tumor size larger than 3cm in diameter, higher expression levels could be detected. Conclusion High expression levels of HGF and TGF-β1 could be detected in the BALF of the patients with ES-NSCLC with high specificity. For this reason, it has certain clinical value in the accessory diagnosis of ES-NSCLC.

Objective To investigate the value of hepatocyte growth factor ( HGF ) and transforming growth factor-β1 (TGF-β1) in the diagnosis of early stage non-small cell lung cancer (ES-NSCLC) through detection of their levels in serum and bronchoalveolar lavage fluid ( BALF ) . Methods Serum and BALF samples were collected from 48 cases of ES-NSCLC ( at stage 1 and 2 ) , 45 cases of medium and advanced NSCLC (at stage 3 and 4), 42 cases of benign pulmonary nodule and 30 controls for the study. The levels of HGF and TGF-β1 were respectively detected by ELISA, and their differences were analyzed between the 4 groups. The relationship between HGF and TGF-β1 levels and tumor size, differentiation and pathological type was further analyzed, and sensitivity and specificity in the diagnosis of ES-NSCLC was evaluated in the study. Results The levels of HGF and TGF-β1 in BALF of the ES-NSCLC group were significantly higher than those in the benign pulmonary nodule group and the normal control group (P <0. 05). HGF and TGF-β1 serum levels in the ES-NSCLC group were higher than those in the benign pulmonary nodule group and the control group, however, no statistical significance could be seen when comparisons were made between them ( P >0. 05). Serum HGF and TGF-β1 levels in the BALF of the medium and advanced NSCLC group were significantly higher than those in the ES-NSCLC group (P<0. 05). The areas under the curve (AUC) in the BALF of HGF and TGF-1 were respectively 0. 754 and 0. 839. When the levels of 59. 32pg/ml and 98. 52pg/ml were selected as the optimal cutoff values according to the Jordan index maximum method, the sensitivity of HGF and TGF-β1 in the diagnosis of ES-NSCLC were respectively 41. 7％ and 81. 3％, and specificity were respectively 96. 3％ and 77. 8％. Furthermore, in the patients with adenocarcinoma or tumor size larger than 3cm in diameter, higher expression levels could be detected. Conclusion High expression levels of HGF and TGF-β1 could be detected in the BALF of the patients with ES-NSCLC with high specificity. For this reason, it has certain clinical value in the accessory diagnosis of ES-NSCLC.

Objective To investigate the structural response of diaphragm and soleus of the rat after mechanical ventilation (MV), and to explore the specific mechanism of the dysfunction of both muscles.Methods Sixteen male Sprague-Dawley (SD) rats were randomly divided into control group and MV group, with 8 rats in each group. Rats in MV group were treated with controlled ventilation and maintained anesthesia, and those in control group were only anesthetized without MV and maintained anesthesia. The diaphragm and soleus were harvested after MV for 18 hours, and the morphology changes were observed with light microscope. The cross section of muscle fiber was observed by immunofluorescence technique analysis, and the cross-sectional area of muscle fiber was calculated. The ultra structural changes in muscle fibers were observed under transmission electron microscope.Results ① Observed under light microscope, the cross section of the diaphragm and soleus muscle in the control group was regular, the nucleus was normal and the cytoplasm was homogeneous. The fibers in the diaphragm-biopsy specimens from MV subjects were smaller than those from control subjects, whereas these signs were not found in soleus. But fiber atrophy in MV specimens was not accompanied by an inflammatory-cell infiltrate. ② Under the fluorescence microscope, the control group had a smaller cross-section of the slow-twitch muscle in diaphragm, while the fast-twitch muscle fibers werelarger. As compared with diaphragm-biopsy specimens from control, specimens from MV subjects showed decreased cross-sectional areas of slow-twitch and fast-twitch fibers, respectively (μm2: 1069.00±155.24 vs. 1297.12±331.15, 2279.66±442.31 vs. 3031.80±596.11, bothP < 0.05). The disproportionate decrease in fast-twitch fibers cross-sectional areas [(70.42±3.61)% vs. (75.63±2.48)%] resulted inan increase in the percentage of total area occupied by the slow-twitch fibers [(29.58±3.61)% vs. (24.35±2.48)%, bothP < 0.01]. There were no significant differences in cross-sectional areas of slow-twitch and fast-twitch fibers in soleus between control group and MV group (μm2: 3193.80±559.36 vs. 3008.84±559.22, 3392.86±514.56 vs. 3594.35±651.67, bothP > 0.05). ③ In the control group, the muscle fibers of the diaphragm and soleus were arranged orderly, the boundary of the light and dark bands and the Z-line were clear, and there was no autophagy in the visual field. The outer membrane of the mitochondria was complete, and the cristae were in the shape of clapboard. The signs of misalignment of myofibrils, disruption of Z-line and vacuolar mitochondria were found in diaphragm from MV group, whereas these signs were not found in soleus. Diaphragm from MV group exhibited an increase in autophagic vesicles visualized by transmission electron microscopy as compared with control group.Conclusions Controlled MV for 18 hours resulted in diaphragmatic inactivity and promoted muscle injury and atrophy, while autophagy and mitochondrial dysfunction were enhanced. Soleus immobilization for 18 hours was not associated with muscle atrophy. These facts suggest that the signaling associated with diaphragm atrophy during MV may involve different mechanisms compared with other models of muscle atrophy. Diaphragm appeared to be more susceptible to MV.

Objective To investigate the effect of calpeptin on diaphragmatic injury and atrophy under controlled mechanical ventilation in rats.Methods A total of 24 SPF Sprague-Dawley (SD) rats were randomly divided into anesthetized control group (CON group),24-hour controlled mechanical ventilation group (CMV group),and 24-hour CMV + treatment with calpeptin group (CMVC group),with 8 rats in each group.Animals in the CON group received an intraperitoneal injection of pentobarbital sodium without CMV and continuous infusion of pentobarbital sodium.A small-animal ventilator was used for 24 hours in rats of CMV group.Rats of CMVC were treated with a specific calpain inhibitor calpeptin (4 mg/kg).The drug was injected subcutaneously 2 hours before and 8,15 and 23 hours after mechanical ventilation.Changes in diaphragm ultrastructure,light microscopic picture,and myosin heavy chain (MHC) expression were observed.Results ① Alignment of myofilaments and normal Z-band,and the shape of mitochondria were maintained in CON group as revealed by electron microscope.The signs of misalignment of myofibrils,disruption of Z-band and vacuolar mitochondria were found in CMV group,and they were obviously improved in CMVC group.The density of muscle injury (× 10-2/μm2) in CMV group was significantly higher than that in control group (36.8 ± 13.7 vs.6.4 ± 6.3,t=6.373,P=0.001),and that in CMVC group was significantly lowered (17.6 ± 9.1 vs.36.8 ± 13.7,t=3.694,P=0.002).② In CON group,the diaphragm fibers appeared regular in cross section without pathologic change under light microscopy.Fuzzy muscle striations,irregular muscle fibers,centralized nuclei and swelling of capillary endothelial cells were observed in CMV group,while pathological changes in the CMVC group were milder significantly.③ In CMV group,the density of MHCslow and MHCfast was lower compared with that of CON group,and the gray value was lowered by 61.1％ (t=8.138,P=0.001) and 77.1％ (t=8.844,P=0.001),respectively,especially in MHCfast.However,the gray values of MHCslow and MHCfast were increased by 1.51 folds (t=4.601,P=0.010),and 1.33 folds (t=2.859,P=0.011),respectively,after treatment with calpeptin,and the elevation was more significantly in MHCslow.Conclusions Diaphragmatic injury and atrophy were found after CMV for 24 hour.Calpeptin could reverse the detrimental effects of CMV,and it suggested that calpain plays an important role in modulating the ventilator-induced dysfunction of the diaphragm.