Objective:To investigate the clinical characteristics of cases with different congenital pulmonary airway malformations (CPAM) volume ratios (CVR) and the effect of maternal glucocorticoid treatment during pregnancy on CPAM.Methods:A retrospective study was conducted on 56 singleton pregnant women with fetal CPAM diagnosed prenatally in the Department of Obstetrics and Gynecology at Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, from September 2020 to May 2023. Among these, three cases received maternal glucocorticoid treatment during pregnancy and clinical conditions were reported in detail. Statistical analyses were performed using independent sample t-tests, non-parametric tests, Chi-square tests, or Fisher's exact test. Results:(1) General information: The average age of the 56 pregnant women with CPAM fetuses was (32.0±0.7) years. All fetuses had unilateral lesions, with 25 cases (44.6%) on the left side. Types Ⅰ, Ⅱ, and Ⅲ CPAM accounted for 5.4% (3/56), 50.0% (28/56), and 44.6% (25/56), respectively. Fetal hydrops occurred in two cases, and the maximum CVR during the fetal period for the other 54 non-hydropic fetuses was 0.79±0.66. (2) The CVR threshold for the risk of fetal hydrops was set as the mean maximum CVR of non-hydropic CPAM fetuses plus 2 standard deviations (0.79+2×0.66=2.1). The subjects were divided into two groups based on the maximum CVR during the fetal period: CVR≤2.0 group ( n=50) and CVR>2.0 group ( n=6). Comparison between the CVR>2.0 group and CVR≤2.0 group: The CVR>2.0 group had significantly higher rates of fetal hydrops [2/6 vs. 0.0% (0/50), Fisher's exact test], mediastinal shift [5/6 vs. 32.0% (16/50), χ 2=4.03], polyhydramnios [6/6 vs. 4.0% (2/50), Fisher's exact test], and postnatal surgery [4/5 vs. 22.2% (10/45), continuity correction χ 2=4.86] (all P<0.05). None of the fetuses with CVR≤2.0 had hydrops or received intrauterine intervention. The overall live birth rate was 89.3% (50/56). (3) Maternal glucocorticoid treatment during pregnancy: three of six fetuses with CVR>2.0 were treated with maternal glucocorticoid during pregnancy, and all were delivered alive at term after the intervention with resolution of edema and/or reduction in mass size. Two of them were treated with postnatal thoracoscopic surgery and were followed up to 5 and 14 months of age, respectively, with no abnormalities in feeding and development; the other was not treated surgically until 3 months of age, with no respiratory-related symptoms and no abnormalities in feeding and development. Conclusions:Prenatal ultrasound indicating CVR>2.0 is associated with increased rates of fetal hydrops, mediastinal shift, and polyhydramnios. Maternal glucocorticoid treatment during pregnancy may lead to favorable pregnancy outcomes for these CPAM fetuses.

Objective:To preliminarily investigate the correlation between right atrial and right ventricular myocardial strain, assessed by two-dimensional speckle-tracking echocardiography (2D-STE), and early death in patients after left ventricular assist device (LVAD) implantation.Methods:A total of 39 patients with end-stage heart failure who underwent LVAD implantation were prospectively included in the First Affiliated Hospital of Xi′an Jiaotong University from April 2022 to March 2024. Routine transthoracic echocardiography (TTE) images were obtained within 3 days before LVAD implantation for all patients to comprehensively assess left ventricular and right ventricular function. The right ventricular free wall longitudinal strain (RVFWSL), right ventricular four-chamber longitudinal strain (RV4CSL), right atrial reservoir strain (RASr), conduit strain (RAScd), and contraction strain (RASct) were measured by using 2D-STE. The primary endpoint was early postoperative mortality. The patients were divided into survival group and death group based on whether died within 3 months after LVAD implantation.Results:Of all the patients, five cases died in hospital after LVAD implantation, with 4 deaths attributed to right heart failure and 1 death to malignant arrhythmia. The RVFWSL and RV4CSL (absolute values) in the death group were significantly lower than those in the survival group (both P<0.05). Cox multivariate regression analysis showed that RVFWSL and RV4CSL were risk factors for death within 3 months [ HR: 0.521(95% CI=0.275-0.986), P=0.045; HR: 0.491(95% CI=0.252-0.958), P=0.037]. Further ROC curve analysis revealed that the diagnostic cutoff value for RVFWSL in predicting death within 3 months was ≤|-12.1|%, with the area under the curve (AUC) of 0.938(0.812-0.990), and the diagnostic cutoff value for RV4CSL was ≤|-14.2|%, with an AUC of 0.926(0.796-0.985). Conclusions:In patients with end-stage heart failure, RVFWSL ≤ |-12.1|% and RV4CSL ≤ |-14.2|% are associated with an increased risk of death within 3 months after LVAD implantation.

Objective:To preliminarily investigate the correlation between right atrial and right ventricular myocardial strain, assessed by two-dimensional speckle-tracking echocardiography (2D-STE), and early death in patients after left ventricular assist device (LVAD) implantation.Methods:A total of 39 patients with end-stage heart failure who underwent LVAD implantation were prospectively included in the First Affiliated Hospital of Xi′an Jiaotong University from April 2022 to March 2024. Routine transthoracic echocardiography (TTE) images were obtained within 3 days before LVAD implantation for all patients to comprehensively assess left ventricular and right ventricular function. The right ventricular free wall longitudinal strain (RVFWSL), right ventricular four-chamber longitudinal strain (RV4CSL), right atrial reservoir strain (RASr), conduit strain (RAScd), and contraction strain (RASct) were measured by using 2D-STE. The primary endpoint was early postoperative mortality. The patients were divided into survival group and death group based on whether died within 3 months after LVAD implantation.Results:Of all the patients, five cases died in hospital after LVAD implantation, with 4 deaths attributed to right heart failure and 1 death to malignant arrhythmia. The RVFWSL and RV4CSL (absolute values) in the death group were significantly lower than those in the survival group (both P<0.05). Cox multivariate regression analysis showed that RVFWSL and RV4CSL were risk factors for death within 3 months [ HR: 0.521(95% CI=0.275-0.986), P=0.045; HR: 0.491(95% CI=0.252-0.958), P=0.037]. Further ROC curve analysis revealed that the diagnostic cutoff value for RVFWSL in predicting death within 3 months was ≤|-12.1|%, with the area under the curve (AUC) of 0.938(0.812-0.990), and the diagnostic cutoff value for RV4CSL was ≤|-14.2|%, with an AUC of 0.926(0.796-0.985). Conclusions:In patients with end-stage heart failure, RVFWSL ≤ |-12.1|% and RV4CSL ≤ |-14.2|% are associated with an increased risk of death within 3 months after LVAD implantation.

Objective : To investigate the effect of lentivirus mediated silencing of NIPBL gene on osteogenic differentiation of mouse bone marrow mesenchymal stem cells ( BMSCs) . Methods : The third generation C57 Mouse Bone marrow mesenchymal stem cells were divided into experimental group , negative control group and blank control group. The lentiviral vector was transfected into mouse bone marrow mesenchymal stem cells , the transfection results were observed by inverted fluorescence microscope , and the expression of NIPBL gene was detected by real- time PCR. The cells of each group were cultured by osteogenic induction. The alkaline phosphatase activity was 2 and RUNX⁃2. Results : The expression of NIPBL mRNA decreased in the experimental group (P < 0. 05) . The activity of alkaline phosphatase in experimental group was lower than that in negative control group and blank control group (P < 0. 05) . The gene transcription and protein expression levels of OCN, BMP⁃2 and Runx⁃2 in experimental group were lower than those in negative control group and blank control group ( P < 0. 05 ) . Alizarin red staining results showed that the negative control group and blank control group had more red calcium nodules than the experimental group. Conclusion Lentivirus mediated silencing of NIPBL gene reduces the proliferation of mouse bone marrow mesenchymal stem cells , inhibits the expression of osteogenic differentiation related genes , and reduces the osteogenic differentiation ability.

Thimerosal has been widely used as a preservative in drug and vaccine products for decades.Due to the strong propensity to modify thiols in proteins,conformational changes could occur due to covalent bond formation between ethylmercury(a degradant of thimerosal)and thiols.Such a conformational change could lead to partial or even complete loss of desirable protein function.This study aims to investigate the effects of thimerosal on the capsid stability and antigenicity of recombinant human papillomavirus(HPV)18 virus-like particles(VLPs).Dramatic destabilization of the recombinant viral capsid upon thimerosal treatment was observed.Such a negative effect on the thermal stability of VLPs preserved with thimerosal was shown to be dependent on the thimerosal concentration.Two highly neutralizing antibodies,13H12 and 3C3,were found to be the most sensitive to thimerosal treatment.The kinetics of antigenicity loss,when monitored with 13H12 or 3C3 as probes,yielded two distinctly different sets of kinetic parameters,while the data from both monoclonal antibodies(mAbs)followed a biphasic expo-nential decay model.The potential effect of thimerosal on protein function,particularly for thiol-containing proteinaceous active components,needs to be comprehensively characterized during formulation development when a preservative is necessary.

Objective:To analyze the clinical characteristics of patients with different types of coronavirus disease 2019 (COVID-19).Methods:A total of 272 eligible COVID-19 patients who were admitted to Guangzhou Eighth People′s Hospital, Guangzhou Medical University from January 22 to February 15, 2020 were retrospectively enrolled. General characteristics, the first laboratory examination and imaging data of these patients were collected. According to the clinical classification, there were 236 cases in non-severe group (mild+ common type) and 36 cases in severe group (severe+ critical type). Comparisons between groups were performed by t test, chi-square test or rank-sum test when appropriate. Results:There were 23 males and 13 females in the severe group, 103 males and 133 females in the non-severe group, and the difference was statistically significant ( χ2=5.149, P=0.023). The age of severe group was (60.5±11.2) years, which was higher than that of non-severe group (46.8±15.7) years. The difference was statistically significant ( t=6.43, P<0.01). The lymphocyte (LYM) count, platelet (PLT) count and arterial partial pressure of oxygen (PaO 2) in the severe group were 0.90(0.55, 1.10)×10 9/L, 170.00(143.50, 198.00)×10 9/L and 73.50(69.70, 83.00) mmHg(1 mmHg=0.133 kPa), respectively, which were all lower than those in the non-severe group (1.42(1.09, 1.95)×10 9/L, 187.00(148.00, 230.00)×10 9/L and 96.00(83.20, 108.00) mmHg, respectively). The differences were all statistically significant ( Z=5.59, 2.00 and 5.00, respectively, all P<0.05). The levels of creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), C reaction protein (CRP) and procalcitonin (PCT) in the severe group were 123.00(79.00, 212.00) U/L, 32.10(27.00, 47.40) U/L, 305.50(216.00, 396.00) U/L, 37.02(23.92, 63.66) mg/L and 0.09(0.05, 0.19) μg/L, respectively, which were all higher than those in the non-severe group (68.00(48.00, 103.00) U/L, 20.10(16.70, 26.20) U/L, 179.00(150.00, 222.00) U/L, 26.55(18.11, 36.96) mg/L and 0.04(0.03, 0.06) μg/L respectively), and the differences were all statistically significant ( Z=3.89, 5.60, 5.12, 2.85 and 5.43, respectively, all P<0.01). No significant differences were observed in white blood cell count, creatine kinase isoenzyme and blood lactate between the two groups ( Z=1.53, 0.41 and 1.00, respectively, all P>0.05). Conclusion:Gender, age, LYM count, PLT count, PaO 2, CK, AST, LDH, CRP and PCT could be used to provide reference for clinical classification of COVID-19 patients.

Objective To study the clinical value of heat shock protein (HSP)70 in the diagnosis of neonatal asphyxia and the correlation of HSP70 and Neonatal Behavioral Neurological Assessment (NBNA)score.Methods From January 2014 to June 2016,full-term neonates born in our hospital were enrolled in the study and assigned into mild and severe asphyxia groups.Normally delivered full-term infants were assigned to the control group.Blood from umbilical artery were extracted immediately after birth and HSP70 levels were detected using ELISA.The NBNA scores were recorded at the 7th,14th and 28th-day after birth.Results HSP70levels in both mild (n =46 )and severe (n =35 )asphyxia groups were significantly higher than the control group(n =50)[(14.4 ±2.7)ng/ml、(17.7 ±4.5)ng/ml than(11 .9 ± 2.3)ng/ml,P <0.05].The severe asphyxia group had even higher HSP70 levels than the mild asphyxia group (P <0.05).The NBNA scores of both asphyxia groups were significantly lower than the control group (P <0.05).The umbilical pH values of both two asphyxia groups were also significantly lower than the control group(P <0.05).Correlation analysis showed that HSP70 level was negative correlated with NBNA score (7th,14th,28th-day)(r =-0.574、-0.493、-0.208,P <0.05).The HSP70 level was negatively correlated with umbilical pH (r =-0.576,P <0.05).The area under curve(AUC)for HSP70 levels to predict asphyxia was 0.798(95%CI 0.722 ~0.874,P <0.05).Conclusions HSP70 level in umbilical cord blood can be used as an indicator for neonatal asphyxia.The more severe the asphyxia,the higher the HSP70 levels and the lower NBNA score and umbilical pH.

Objective To screen the neonatal malrotation with PITX2 gene exon 2 and 5 gene mutation through the study on molecular genetics.Methods From January 201 2 to December 201 4,1 5 cases of neonatal malro-tation infants(experimental group)and 25 healthy newborn infants(healthy control group)were selected as the research subjects from the First Affiliated Hospital of Shihezi University Medical College.The experimental group included 1 5 ca-ses of volvulus,4 cases of volvulus with duodenal atresia and 3 cases of volvulus with jejunal atresia.The clinical fea-tures were recorded and 3 mL peripheral venous blood from each subject was collected.After ethylenediamine tetraacetic acid (EDTA)anticoagulation,genomic DNA was extracted.Polymerase chain reaction (PCR)was used to amplify the exon 2 and exon 5 of PITX2 gene,and the direct sequencing method was used to screen whether there were mutations in these 2 loci.Results According to the findings of the matching gene,PITX2 gene exon 2 and exon 5 mutations were not detected in 15 cases with intestinal malrotation of the experimental group and 25 healthy newborns in the healthy control group.Conclusions Polymorphisms is not detected in PITX2 gene exon 2 and exon 5 in small groups of newborn,but this does not exclude the possibility the gene caused newborns suffering from intestinal malrotation by other means.

OBJECTIVETo investigate the changes in mRNA expression of p53 and related downstream genes in peripheral blood lymphocytes in workers occupationally exposed to arsenic as well as its influencing factors, and to analyze the mechanism of genetic toxicity of arsenic.

METHODSWith cluster random sampling, 79 workers from an arsenic smelting plant were selected as exposure group, and another 24 people without occupational exposure to arsenic were selected as control group. The relative mRNA expression of p53 and related downstream genes in the peripheral blood lymphocytes of the two groups was determined by quantitative realtime PCR. The levels of inorganic arsenic (iAs), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) in urine were determined by hydride generation-atomic absorption spectrometry.

RESULTSThe exposure group had significantly higher levels of iAs, MMA, and DMA than the control group (P<0.01); the exposure group had significantly higher relative mRNA expression (2(-ΔΔCt)) of p53 and four related downstream genes in peripheral blood lymphocytes than the control group (P<0.05); the relative mRNA expression of p53 and related downstream genes was positively correlated with each other (P<0.01), with a correlation coefficient greater than 0.4; the levels of arsenic compounds in urine were positively correlated with the relative mRNA expression of p53 and some of its downstream genes (P<0.05).

CONCLUSIONThe changes in mRNA expression of p53 and related downstream genes are closely related to the metabolic transformation of inorganic arsenic in workers occupationally exposed to arsenic, and it also plays an important role in genetic toxicity and carcinogenic effect in people exposed to arsenic.

Arsenic ; adverse effects ; urine ; Arsenicals ; urine ; Cacodylic Acid ; urine ; Case-Control Studies ; Humans ; Lymphocytes ; drug effects ; Occupational Exposure ; RNA, Messenger ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Background and purpose: Multidrug resistance (MDR) is the dominating obstacle to the chemotherapy. There is strong evidence that the phosphoinositide 3-kinases (PI3Ks) signaling pathway is involved in MDR phenotype, however, the mechanism of MDR occurrence is still unknown. This study tended to investigate the regulating effect of PI3K/Akt signaling pathway and its downstream target genes in P-glycoprotein (P-gp) (ABCB1 gene encoding)-mediated MDR in human colon carcinoma HCT-116/L-OHP cells. Methods:Pretreatment with PI3K selective inhibitor LY294002 (20μmol/L) for 2 h, the sensitivity of L-OHP was evaluated by the CCK-8 (cell counting kit-8) assay in HCT-116/L-OHP cells, and the expressions of P-gp, LRP, MRP-2, Akt, p-Akt, IκB and p-IκB were evaluated by Western blot. The activity of ABCB1 promoter was evaluated by chromatin immunoprecipitation analysis (CHIP). Results: After inhibiting the activity of PI3K/Akt signaling pathway, the IC50 value of L-OHP decreased from(157.48±16.73)μg/mL to (53.68±3.18)μg/mL in HCT-116/L-OHP cells, and the reversal index was 2.93 (P<0.01). The expressions of P-gp, p-Akt and p-IκB were down-regulation compared with the concrol group (P<0.01), but the expressions of LRP, MRP-2, Akt and IκB didn't change signiifcantly. CHIP result has conifrmed that NF-κB protein could bind to the region of ABCB1 gene promoter in HCT116/L-OHP cells. Conclusion:Blocking of PI3K/Akt/NF-kB signal pathway could increase the drug sensitivity to MDR cells, inhibit the phosphorylation of p-Akt and p-IκB, and reversing ABCB1/P-glycoprotein-mediated multidrug resistance in colon carcinoma cells.