Objective To evaluate the impact of an integrated management mode of prenatal diagnosis-postnatal treatment for congenital heart disease (CHD) on perioperative and long-term outcomes of the arterial switch operation (ASO), and to analyze the efficacy of ASO in a single center. Methods This retrospective study analyzed the clinical data of 183 children who underwent ASO at Guangdong Provincial People’s Hospital from 2018 to 2024. The cohort included 106 (57.9%) patients of transposition of the great arteries with intact ventricular septum (TGA/IVS), 61 (33.3%) patients of transposition of the great arteries with ventricular septal defect (TGA/VSD), and 16 (8.7%) patients of Taussig-bing anomaly (TBA). Perioperative indicators were compared between 91 patients in the prenatal-postnatal integrated management group (an integrated group) and 92 patients in the traditional management group (a non-integrated group). Long-term survival and reoperation rates were analyzed using Kaplan-Meier curves. Results The overall perioperative mortality rate was 4.9% (9/183), showing a downward trend year by year. The primary cause of perioperative mortality was low cardiac output syndrome (LCOS), which occurred in 12 patients (6.6% incidence) with a mortality rate of 75.0%. The integrated group had a higher proportion of males (89.0% vs. 72.8%, P<0.05) and lower body weight [3.1 (2.7, 3.3) kg vs. 3.3 (3.0, 3.7) kg, P<0.05] compared to the non-integrated group. The age at surgery was significantly earlier in the integrated group [7 (3, 10) d vs. 14 (9, 48) d, P<0.05], and all children in the integrated group underwent ASO within the optimal surgical window (100.0% vs. 82.6%, P<0.05). Intraoperatively, cardiopulmonary bypass time [173 (150, 207) min vs. 186 (159, 237) min, P<0.05] and aortic cross-clamp time [100 (90, 117) min vs. 116 (97, 142) min, P<0.05] were significantly shorter in the integrated group. Although the integrated group had longer postoperative mechanical ventilation time [145 (98, 214) h vs. 116 (77, 147) h, P<0.05] and higher 48-hour maximum vasoactive inotropic score [15 (10, 21) points vs. 12 (8, 16) points, P<0.05], there was no statistically significant difference in the incidence of severe complications (LCOS, necrotizing enterocolitis, extracorporeal membrane oxygenation) or mortality rate (3.3% vs. 6.5%, P=0.51) between the two groups, despite earlier surgical intervention and a higher proportion of critically ill cases in the integrated group. The length of hospital stay in the emergency surgery group was significantly shorter than that in the elective surgery group [20 (15, 28) d vs. 25 (21, 30) d, P<0.05], suggesting that early surgery may be of potential benefit. A total of 163 patients were successfully followed up for a median of 4.7 years, with a 5-year survival rate of 95.1% and a freedom from reintervention survival rate of 95.1%. There were no late deaths, and the most common postoperative complication was pulmonary artery stenosis. Conclusion The integrated management model allowed critically ill children with lower body weights to safely undergo surgery, significantly optimizing the timing of surgery and shortening intraoperative times. The long-term risk of reoperation after ASO is primarily concentrated on pulmonary artery stenosis, necessitating long-term follow-up and monitoring.

This study explores whether the current external quality assessment (EQA) level and acceptable bias for basic semen analysis in China are clinically useful. We collected data of semen EQA from Andrology laboratories in the Hunan Province (China) in 2022 and searched for data in the published literature from January 2000 to December 2023 in China. On the basis of these data, we analyzed the coefficients of variation and acceptable biases of different quality control materials for basic semen analysis through robust statistics. We compared these findings with quality specifications based on biological variation from optimal, desirable, and minimum levels of bias to seek a unified and more suitable semen EQA bias evaluation standard for China's national conditions. Different sources of semen quality control material exhibited considerable variation in acceptable biases among laboratories, ranging from 8.2% to 56.9%. A total of 50.0% of the laboratories met the minimum quality specifications for progressive motility (PR), whereas 100.0% and 75.0% of laboratories met only the minimum quality specifications for sperm concentration and total motility (nonprogressive [NP] + PR), respectively. The Z value for sperm concentration and PR+NP was equivalent to the desirable performance specification, whereas the Z value for PR was equivalent only to the minimum performance specification. This study highlights the feasibility of operating external quality assessment schemes for basic semen analysis using quality specifications based on biological variation. These specifications should be unified among external quality control (EQC) centers based on biological variation.
Semen Analysis/standards* ; Humans ; China ; Male ; Quality Control ; Sperm Motility ; Sperm Count/standards*

OBJECTIVES: To investigate the characteristics and clinical significance of anorectal manometry measurements in children with tethered cord syndrome (TCS) before and after surgery. METHODS: A retrospective study was conducted on 44 children with TCS treated at the Children's Hospital of Zhejiang University School of Medicine from January 2022 to September 2023. These patients were divided into effective subgroup (n=34) and non-effective subgroup (n=10) based on postoperative symptom improvement. Additionally, 34 children with functional constipation were selected as a control group. Baseline data and manometry measurements were compared between the preoperative TCS group and the control group, as well as between the non-effective and effective subgroups. RESULTS: The TCS group had lower short contraction time and defecation relaxation rate compared to the control group (P<0.05), while defecation residual pressure and maximum rectal tolerable threshold were higher than the control group (P<0.05). The length of the anal canal in the high-pressure zone in the effective subgroup was greater postoperatively than preoperatively (P<0.05), and the initial rectal sensation threshold decreased postoperatively (P<0.05). The non-effective subgroup had lower preoperative maximum rectal expulsion pressure compared to the effective subgroup (P<0.05). Postoperative rectal anal inhibition reflex values in the effective subgroup were higher than those in the non-effective subgroup (P<0.05). CONCLUSIONS There are some differences in anorectal dynamics between children with TCS and those with functional constipation. Maximum rectal expulsion pressure may be a key predictor of surgical outcomes. Surgery can alter certain defecation functions in some children.
Humans ; Male ; Anal Canal/physiopathology* ; Female ; Rectum/physiopathology* ; Child ; Child, Preschool ; Retrospective Studies ; Manometry ; Neural Tube Defects/physiopathology* ; Infant ; Defecation ; Adolescent ; Constipation/physiopathology* ; Clinical Relevance

Direct electrical stimulation of the human cortex can produce subjective visual sensations, yet these sensations are unstable. The underlying mechanisms may stem from differences in electrophysiological activity within the distributed network outside the stimulated site. To address this problem, we recruited 69 patients who experienced visual sensations during invasive electrical stimulation while intracranial electroencephalography (iEEG) data were recorded. We found significantly flattened power spectral slopes in distributed regions involving different brain networks and decreased integrated information during elicited visual sensations compared with the non-sensation condition. Further analysis based on minimum information partitions revealed that the reconfigured network interactions primarily involved the inferior frontal cortex, posterior superior temporal sulcus, and temporoparietal junction. The flattened power spectral slope in the inferior frontal gyrus was also correlated with integrated information. Taken together, this study indicates that the altered electrophysiological signatures provide insights into the neural mechanisms underlying subjective visual sensations.
Humans ; Male ; Female ; Adult ; Visual Perception/physiology* ; Electric Stimulation ; Middle Aged ; Young Adult ; Electrocorticography ; Electroencephalography ; Brain Mapping

Objective To explore the correlation between the rs7296288 single nucleotide polymorphism(SNP)of the DHH gene and the onset of depression.Methods From March 2018 to December 2019,480 patients with depression in Sichuan Provincial People's Hospital,Jining Mental Hospital,Yunnan Mental Health Center were collected as the case group,and 329 patients without depression were collected as the control group.Peripheral blood samples were collected and DNA was extracted.After multiple amplification and high-throughput sequencing,statistical software was used to analyze the relevant data.Results The rs7296288 polymorphism of the DHH gene,the AA genotype was 32.9％in the control group and 36.7％in the case group,with no statistical difference;the AC genotype was 52.8％in the control group and 47.7％in the case group,with no statistical difference;the CC genotype was 14.3％in the control group and 15.6％in the case group,with no statistical difference.The co-dominant,dominant,and recessive statistical models were not statistically significant.Subgroup analysis of the degree of depressive episodes,suicide attempts,and first-episode patients did not find an association between the rs7296288 SNP locus of the DHH gene and the clinical features of depression,that is,the SNP rs7296288 of the DHH gene had no significant correlation with depression.Conclusion The rs7296288 polymorphism of DHH gene is not correlated with the pathogenesis of depression.

Objective To establish a low density, high purity and high stability in vitro culture method of primary hippocampal neurons of fetal rats by co-culturing hippocampal and cortical cells, so as to obtain higher purity and better vitality of primary hippocampal neurons disease. Methods The fetal rat hippocampal tissue was isolated from 16-18 days pregnant SD rats, then cut and digested by 0.125% trypsin. The obtained cell suspension was filtered by 200 mesh cell sieve, and then the obtained cell suspensions were then inoculated into the inner layer and outer ring of the culture plate in a surrounding form. They were co-cultured in DMEM/F12 medium containing 10% horse serum. After 4-6 hours of cell adhesion, the culture medium was changed to maintenance medium (Neurobasal+2% B27+0.5 mmol/L glutamine). Then the cell viability was detected with CCK-8 kit and the purity of hippocampal neurons was detected by immunofluorescent staining. Results Hippocampal neurons grew well and formed crisscross neural networks after 5 days. And it could survive for 3 weeks. The purity of hippocampal neurons was up to 98%. Conclusion The method of co-culturing hippocampal and cortical cells can obtain high-purity, high activity, high survival rate, and high stability primary hippocampal neurons from fetal rats, which can provide certain experimental conditions for the study of hippocampal neuron related diseases in the nervous system and is worthy of promotion and application.

Objective To investigate the association of 13 single nucleotide polymorphism(SNP)sites in 6 phalange-bone development related genes[fibroblast growth factor receptor 2(FGFR2),indian hedgehog signaling molecule(IHH),Msh homeobox 1(MSX1),Runx family transcription factor 2(RUNX2),SRY-box transcription factor 9(SOX9),Wnt family member 5A(WNT5A)]with human index-ring finger length ratio(2D∶4D).Methods Digital cameras were used to take frontal photographs of the hands of 731 college students(358 males and 373 females)in Ningxia,and image analysis software was used to mark anatomical points and measure finger lengths of index(2th)and ring(4th);genotyping of 13 SNP sites(rs1047057,rs755793,rs41258305,rs3731881,rs3100776,rs12532,rs3821949,rs45585135,rs3749863,rs1042667,rs12601701,rs1829556,rs3732750)for 6 genes by multiplex PCR;One-Way ANOVA or independent sample t-test indirectly assessed the association between 2D∶4D and 13 SNP sites.Results Both left and right hand 2D∶4D were significantly higher in females than males in Ningxia college students(all P<0.01);no statistically significant differences in genotype and allele frequencies of the 13 SNP sites among different sexes(all P>0.05);among different sexes,male left hand 2D∶4D was significantly associated with the genotype of SOX9 gene rs12601701 site(P<0.05)and right hand 2D∶4D was significantly associated with the genotype of WNT5A gene rs1829556 site(P<0.05);the female right hand 2D∶4D was significantly associated with the MSX1 gene rs12532(P<0.01)and rs3821949(P<0.05)sites genotypes.Conclusion SOX9(rs12601701),WNT5A(rs1829556)and MSX1(rs12532 and rs3821949)gene polymorphisms may be associated with the formation of 2D∶4D in Ningxia population.

OBJECTIVE To improve the quality evaluation method of Platycodonis Radix, to study the differences in the quality of three-years-old Platycodonis Radix under different harvesting periods, and to determine the optimal harvesting period of Platycodonis Radix. METHODS The leachate, ash, moisture, refractive index and the content of six saponins were used as the quality evaluation indexes. The differences between the herbs of Platycodonis Radix at different harvesting periods were characterized with the help of mathematical and statistical methods. And link the entropy weight method, gray correlation analysis and TOPSIS method were combined to obtain the statistical analysis of the relevant indexes and the quality ranking information of the herbs in different harvesting periods. RESULTS There were significant differences between the quality evaluation indexes of three-years-old Platycodonis Radix at different harvesting periods. The added multi-indicator testing had improved the quality evaluation system of Platycodonis Radix and enhanced the "Drug properties-Effectiveness" linkage of the herbs. And the results of the comprehensive quality evaluation model showed that the herbs harvested around October 21 (Frost’s Descent) were ranked best in terms of comprehensive index. CONCLUSION In order to ensure the quality of Platycodonis Radix, the best harvesting period for three-years-old Platycodonis Radix is determined around the "Frost’s Descent" season, taking into account the characteristics of the herbs' appearance and the material basis of herbs.

ObjectiveBased on cyclic adenosine monophosphate （cAMP）/cAMP-regulated guanine nucleotide exchange factor 1 （Epac1）/Ras-homologous protein 1 （Rap1） signaling pathway to explore the myocardial protective mechanism of Yiqi Huoxue prescription on coronary heart disease （CHD） rats with Qi deficiency and blood stasis syndrome. MethodEighty-eight specific-pathogen-free （SPF） grade male Sprague-Dawley （SD） rats were divided into a sham operation group （n=12） and an experimental group （n=76） according to the random number table. The experimental group underwent a restricted diet and exhaustive swimming combined with left anterior descending （LAD） coronary artery ligation to construct a model of CHD with Qi deficiency and blood stasis syndrome， and electrocardiograms （ECGs） of rats before and after the LAD operation were collected. After the model was successfully established， the rats were randomly divided into model group， Yiqi Huoxue prescription low-dose group （4.28 g·kg^-1）， medium-dose group （8.55 g·kg^-1）， high-dose group （17.1 g·kg^-1）， and Western medicine group （isosorbide mononitrate tablets， 3.6 mg·kg^-1）. Rats were intragastrically administered assigned drugs for 4 weeks consecutively， while the sham operation group and the model group were administered with equal volumes of double distilled water. Twenty-four hours after the final administration， the rats were anesthetized with isoflurane to detect the left ventricular end-diastolic diameter （LVEDD）， left ventricular end-systolic diameter （LVESD）， left ventricular fractional shortening （FS， %）， and ejection fraction （EF， %） by echocardiography. Blood samples were collected from the abdominal aorta for hemorheological measurements， and plasma cAMP levels were determined using enzyme-linked immunosorbent assay （ELISA）. Myocardial tissue was collected for hematoxylin-eosin （HE） staining and Masson staining to observe myocardial pathological damage， and a transmission electron microscope was used to observe ultrastructural changes of myocardial tissue， fluorescent quantitative real-time polymerase chain reaction （Real-time PCR） was used to detect the expressions of myocardial Epac1， Rap1 GTPase activating protein （Rap1GAP） and Rap1 mRNA， and Western blot was used to detect the expressions of myocardial Epac1， Rap1GAP and Rap1 protein. ResultCompared with those in the sham operation group， LVEDD and LVISD of rats in the model group significantly increased （P<0.01）， and the ratios of EF and FS significantly decreased （P<0.01）， indicating symptoms of heart function decline， referred to as "heart Qi deficiency". The viscosity of whole blood and plasma significantly increased （P<0.01）， and the content of cAMP significant increased （P<0.01）. In addition， there was a significant proliferation of collagen fibers in myocardial tissue （P<0.01）， and the ultrastructure of the myocardial tissue was severely damaged， indicating pathological changes consistent with "blood stasis". Real-time PCR results showed that Epac1 and Rap1 mRNA levels in the model group were significantly reduced （P<0.01）， while Rap1GAP mRNA levels were significantly increased （P<0.01）. Western blot analysis showed a significant decrease in Epac1 protein expression （P<0.01） and a significant increase in Rap1GAP protein expression （P<0.05）. Compared with the model group， Yiqi Huoxue prescription improved cardiac function， reduced blood viscosity， lowered plasma cAMP levels， decreased collagen fiber proliferation， and improved myocardial ultrastructure damage in CHD rats with Qi deficiency and blood stasis syndrome. The high-dose group showed the most significant effects. In the high-dose group， Epac1 mRNA and protein expression levels significantly increased （P<0.01）， Rap1 mRNA expression significantly increased （P<0.01）， and Rap1GAP mRNA and Rap1GAP/Rap1 protein expression levels significantly decreased （P<0.05， P<0.01）. ConclusionYiqi Huoxue prescription can improve cardiac function， reduce blood viscosity and plasma cAMP levels， improve myocardial damage， and reduce collagen fiber proliferation in CHD rats with Qi deficiency and blood stasis syndrome. The myocardial protection mechanism may be related to the regulation of the cAMP/Epac1/Rap1 signaling pathway.

Objective To observe the clinical effect of acupuncture at the core muscle group combined with rehabilitation training in the treatment of chronic non-specific low back pain.Methods A total of 96 patients with chronic non-specific low back pain were randomly divided into observation group and control group,48 cases in each group.The control group was given rehabilitation training,and the observation group was given acupuncture at core muscle group training on the basis of the control group.Patients in both groups were treated continuously for two weeks.After two weeks of treatment,the clinical efficacy of the two groups was evaluated.The changes of root mean square(RMS)values of transverse abdominal muscle and multifidus muscle were observed before and after treatment,as well as the scores of Oswestry Dysfunction Index,Roland-Morris Dysfunction Questionnaire and Quebec Low Back Pain Scale.The changes of serum β-endorphin,serum substance P and serum prostaglandin E2 levels were compared before and after treatment between the two groups.The patients were followed up for five months after treatment,and the recurrence of the two groups was evaluated.Results(1)The total effective rate was 93.75%(45/48)in the observation group and 81.25%(39/48)in the control group.The curative effect of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the Oswestry Dysfunction Index score,Roland-Morris Dysfunction Questionnaire score and Quebec Low Back Pain Disorder Scale score of the two groups were significantly improved(P＜0.05),and the improvement of Oswestry Dysfunction Index score,Roland-Morris Dysfunction Questionnaire score and Quebec Low Back Pain Disorder Scale score in the observation group was significantly superior to that in the control group,the difference was statistically significant(P＜0.05).(3)After treatment,the RMS values of transverse abdominal muscle and multifidus muscle in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the RMS values of transverse abdominal muscle and multifidus muscle,the difference being significant(P＜0.05).(4)After treatment,the levels of β-endorphin,substance P and prostaglandin E2 in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the levels of β-endorphin,substance P and prostaglandin E2,the differences were statistically significant(P＜0.05).(5)After treatment,the recurrence rate of the observation group was 6.25%(3/48),and that of the control group was 20.83%(10/48).The recurrence rate of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Acupuncture at the core muscle group combined with rehabilitation training in the treatment of chronic non-specific low back pain can significantly improve the clinical symptoms of patients,improve the levels of β-endorphin,substance P and prostaglandin E2,and the clinical effect is significant.