Objective To investigate the role and prognostic value of matrix metalloproteinase-7(MMP7)in the migration and immune cell infiltration of hepatocellular carcinoma.Methods MMP7_siRNA for downregulating the target gene MMP7 and pMMP7 for upregulating MMP7 were constructed and were used to transfect hepatocellular carcinoma cell line(MHCC97H).RT-qPCR and Western Blot were used to measure the mRNA and protein expression levels of the target gene in cells.Scanning electron microscopy and Transwell assay were used to observe the changes in cell pseudopodia and migration ability,and bioinformatics methods were used to investigate the correlation of MMP7 with immune cells and immune infiltration score in TCGA and TIMER databases in patients with hepatocellular carcinoma,as well as the association between MMP7 and the prognosis of patients with hepatocellular carcinoma.The Spearman method was used for correlation analysis.Sanger Box online tool was used to assess the value of MMP7 in the overall survival curve and disease-specific survival of hepatocellular carcinoma.The Kaplan-Meier method was used to plot survival curves,and the Log-rank test was used for comparison of prognosis between different samples.Results After MHCC97H cells were transfected with MMP7_siRNA or pMMP7,there was a significant reduction or increase in the expression of the target gene MMP7;after downregulation of MMP7,there were significant reductions in the number and length of the pseudopodia,while after MMP7 overexpression,there were significant increases in the number and length of filopodia with radial arrangement.The Transwell chamber assay showed that MMP7_siRNA2 significantly reduced the migration ability of cells(P<0.05),and there was a significant increase in migration ability after pMMP7 transfection.The expression of MMP7 was significantly correlated with B lymphocytes(r=0.37,P<0.05),CD4+T lymphocytes(r=0.40,P<0.05),neutrophils(r=0.49,P<0.05),macrophages(r=0.49,P<0.05),and dendritic cells(r=0.47,P<0.05).In the TCGA database,the patients with hepatocellular carcinoma were divided into MMP7 high expression group with 267 patients and MMP7 low expression group with 146 patients based on overall survival,and the results showed that the MMP7 high expression group had a significantly shorter overall survival time than the MMP7 low expression group(P<0.05);based on the disease-specific survival time,the patients were divided into MMP7 high expression group with 257 patients and MMP7 low expression group with 145 patients,and the analysis showed that the MMP7 high expression group also had a significantly shorter disease-specific survival time than the MMP7 low expression group(P<0.05).Conclusion MMP7 promotes the migration of hepatocellular carcinoma cells and plays a major role in immune cell infiltration,and the expression of MMP7 is also significantly associated with the prognosis of hepatocellular carcinoma.

Objective:Interruption of aortic arch(IAA)is a rare congenital heart disease.This study aims to investigate echocardiographic features and pathological ultrastructural characteristics of fetal IAA and to further analyze its pathological evolution. Methods:A retrospective analysis was conducted on prenatal echocardiographic,post-surgical,or autopsy findings of fetuses prenatally diagnosed with IAA.Prenatal echocardiographic tracking was used to observe the internal diameters and Z-scores of different segments of the aortic arch and the changes in the narrowed section.These observations were combined with autopsy and pathological findings to explore the potential intrauterine evolution of IAA and its cytological basis. Results:The study included 34 fetuses with IAA,with 3,3,and 28 fetuses prenatally diagnosed with aortic arch dysplasia(AAD),coarctation of aorta(CoA),and IAA,respectively.The 3 AAD and 3 CoA fetuses chose termination of pregnancy 1 to 2 weeks after prenatal ultrasound diagnosis,and autopsy confirmed IAA.Among the 28 fetuses prenatally diagnosed with IAA,6 cases of CoA progressively worsened,eventually evolving into type A IAA as observed through echocardiographic follow-up.The remaining 22 cases were diagnosed as IAA on the first prenatal ultrasound.Postnatal surgery corrected 3 cases,while 27 cases opted for pregnancy termination,and 4 cases resulted in intrauterine death.Echocardiographic features of the fetal IAA included a significantly smaller left ventricle compared with the right or negligible difference on the four-chamber view,a significantly smaller aorta than the pulmonary artery on the three-vessel view,and a lack of connection between the aorta and the descending aorta on the three-vessel-trachea and aortic arch views.The aortic arch appears less curved and more rigid,losing the normal"V"shape between the aorta,ductus arteriosus,and descending aorta.Color Doppler ultrasound showed no continuous blood flow signal at the interruption site,with reversed blood flow visible in the ductus arteriosus.Transmission electron microscopy of 7 IAA fetuses revealed numerous disorganized smooth muscle cells between the elastic membranes near the aortic arch interruption site,significantly increased in number compared with the proximal ascending aorta.The elastic membranes were thicker and more twisted near the interruption site.The interruption area lacked normal endothelial cells and lumen,with only remnants of necrotic endothelial cells,disorganized short and thick elastic membranes,and randomly arranged smooth muscle cells. Conclusion:Prenatal echocardiography is the primary diagnostic tool for fetal IAA.Post-surgical follow-up and autopsy help identify complications and disease characteristics,enhancing diagnostic accuracy.Some fetal IAA may evolve from AAD or CoA,with potential pathogenesis related to ischemia,hypoxia,and migration of ductal constrictive components.

Abstract OBJECTIVE To conduct a quality markers(Q-Markers) study on the treatment of cough with Feire Zhike granules based on the “five principles” of Q-Markers, combined with mass spectrometry, network pharmacology and cobweb model. METHODS Identification of the main chemical components in Feire Zhike granules by liquid mass spectrometry. The TCMSP database was searched to collect the active ingredients and corresponding targets of 11 herbs in the prescription of Feire Zhike granules. The GeneCards database was also searched to collect genes encoding cough-related proteins, and a herb-component-target network map was constructed. Assigning effectiveness to active ingredients based on the number of target sites. Check the pharmacopoeia and literature to obtain the measurable components of each herb. Determine the monarchical, ministerial and adjuvant attribution of the original herbs in the compound formula based on the principle of compatibility. The literature and TCMSP database were searched to screen the original herb for specificity components. RESULTS A total of 43 chemical components in the Feire Zhike granules were identified to be “delivered” to the formulation based on UHPLC-Q-TOF-MS/MS. The 124 active compounds were obtained from the TCMSP database and acted on 120 targets, 93 of which were associated with coughing. There were 6 components in the pharmacopoeia that specify quantitative methods. A total of 26 endemic components were found in 11 herbs in the compound formula. In addition, the above components were ranked according to the compatibility rules of monarch and minister and the scoring rules of cobweb model. The top 10 components were wogonin, baicalein, licochalcone A, nobiletin, acacetin, hesperidin, liquiritin, tuberstemonine, β-sitosterol and galangin, respectively. CONCLUSION The above 10 components can be identified as Q-Markers of Feire Zhike granules.

Objective:To explore the method of ultrasonography for detecting the fetal umbilical vein diameter, blood flow volume and normalized volume blood flow and establish normal reference ranges with umbilical vein diameter, blood flow volume and normalized blood flow and Z-scores for umbilical vein diameter and blood volume flow.Methods:This was a prospective study on 907 normal fetuses in the Second Xiangya Hospital, Central South University and Women and Children Healthcare Hospital of Zhuzhou from March 2019 to December 2020. The umbilical vein diameter (Duv), umbilical vein blood flow volume (Quv) and normalized volume blood flow (nQ = Quv/estimated fetal weight) of the free loop of umbilical vein (FUV) and fetal intra-abdominal umbilical vein (IUV) were collected. And the mean values and 90% confidence intervals of Duv, Quv and nQ in two segments of umbilical veins at different gestational ages were calculated. Regression analysis of Duv, Quv and nQ were performed with gestational age (GA), and the parameters of umbilical vein in different segments were compared. Finally, with gestational age (GA) as the independent variable, Z-scores of the Duv and Quv were built.Results:The mean values and 90% confidence intervals of Duv, Quv, and nQ in 858 (94.6%) normal fetal umbilical veins were successfully obtained. The Duv, Quv of the FUV and IUV increased as pregnancy progressed. The Quadratic curve of Duv and Linear curve of Quv were of the highest fitnesses, respectively( r=0.951, 0.941, 0.986, 0.982; all P<0.001). While nQ increased with GA followed by a decreased trend, and the Quadratic curve was the highest fitting curve of nQ( r=0.610, 0.611; all P<0.001). Duv-FUV was greater than Duv-IUV( P<0.001), nQ-FUV was bigger than Quv-IUV( P=0.001), and he difference was not statistically significant between Quv-FUV and Quv-IUV( P=0.133). Z-scores models of Duv and Quv were successfully established, and all Z-scores were Gaussian distribution. Conclusions:The normal ranges and Z-scores of umbilical vein parameters are useful to improve the evaluation of placental circulation and provide a strong basis for the monitoring of fetus-related diseases and the evaluation of pregnancy prognosis. The choice of FUV or IUV umbilical vein to evaluate placental circulation may depend on the actual situation in clinical application.

PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
Adrenal Cortex Hormones ; Asthma ; China ; Comorbidity ; Disease Progression ; Education ; Female ; Food Hypersensitivity ; Hospitalization ; Humans ; Hypertension ; Inpatients ; Medication Adherence ; Mortality ; Multivariate Analysis ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors ; Seasons ; Self Care ; Smoke ; Smoking

Objective To summarize the clinical characteristics of hepatic lymphoepithelioma-like carcinoma,and to explore the diagnosis and treatment strategies of hepatic lymphoepithelioma-like carcinoma.Methods A retrospectively analysis on 13 patients with liver lymphoepithelioma-like carcinoma in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,between March 2005 and May 2019 were carried out.Results 8 cases were male,5 were female,median age was 45years (27 to 68 y).There were 8 cases of intrahepatic cholangiocytic lymphoepithelioma-like carcinoma,4cases of hepatocytic lymphoepithelioma-like carcinoma,and 1 case of mixed hepatocytic and cholangiocytic lymphoepithelioma-like carcinoma.All patients received partial hepatectomy and postoperative comprehensive treatment.The patients were followed from 6 months to 7 years.Only one patient died,and the other patients were all in a tumor-free state.Conclusion Primary hepatic lymphoepithelioma-like carcinoma is a rare liver cancer.It is confirmed mainly by pathological examination and immunohistochemistry.With surgery as the main treatment,prognosis is usually fair.

Objective:To investigate the ultrasonographic features and prognosis of fetal vascular anomalies.Methods:Thirty-one fetuses with vascular anomalies diagnosed from June 2013 to August 2018 in Changsha Hospital for Maternal and Child Health Care were retrospectively analyzed. The location, size, shape, internal echo and blood flow distribution of the lesions were observed by ultrasound carefully, and the prognosis was followed up and analyzed.Results:Among the 31 cases of fetal vascular anomalies, 10 cases were comfirmed by autopsy after induced labor, and 21 cases were confirmed by postpartum local observation or surgery and pathology. Among them, there were 4 cases of Klippel-Trenaunay syndrome (including 1 case of Parkes-Weber syndrome), 3 cases of hemangioma, 1 case of primary congenital lymphedema and 23 cases of lymphangioma. Thirty-one cases showed lesions coincident with ultrasound localization and diagnosis, including 9 cases of head and neck lesions, 15 cases of trunk lesions, 1 case of upper limb lesion and 6 cases of lower limb lesions. The blood flow spectra of arteriovenous fistulas were found in 3 cases of fetal lesions and no obvious blood flow signals were found in 28 cases of fetal lesions.Conclusions:Prenatal ultrasound examination and follow-up play an important role in the diagnosis and prognostic prediction of fetal vascular diseases. The prognosis of fetal vascular diseases is closely related to the location, size, effect on the surrounding tissue and shunt volume of the lesion.

Objective:To develop Z-scores for the aortic arch in normal fetuses as a reference for fetuses with suspected coarctation of aorta(CoA).Methods:The aortic arch inner diameters of 610 normal fetuses and 59 CoA fetuses from May 2010 to March 2015 in the Second Xiangya Hospital of Central South University were measured at the long axis of the aortic arch view. Gestational age(GA), femur length(FL) as the independent variable, the aortic arch inner diameters as the dependent variable, Z-scores were created relating the aortic arch inner diameters to the GA and FL. Z-score=[ln(measured diameter)-ln(predicted diameter)]/root MSE. Z-scores of the CoA fetuses were calculated with the above regression, and compared with the Z-scores of the control group.Results:A simple linear regression model was the best description of the data in each case and correlations between FL and the aortic arch inner diameters were excellent ( P<0.001). There was no significant difference in Z-scores calculated with FL or GA as independent variables ( P>0.05). Z-scores of the control group was between -2 and + 2, Z-scores of the CoA group was significantly lower and below -2( P<0.001). Conclusions:Z-scores of fetal aortic arch are sensitive indicators of fetal coarctation, and are of clinical importance for the diagnosis and follow-up study of CoA.

Objective:To explore the variation of renal volume with gestational age(GA), biparietal diameter(BPD), abdominal circumference(AC), femur length (FL) and the Z value calculation formula.Methods:Five hundred and eighty singleton pregnancy women from 20th to 38th gestational weeks in Second Xiangya Hospital of Central South University were enrolled. Two dimensional ultrasound was performed to record fetal growth parameters and renal longitudinal, transverse, anteroposterior diameters. Renal volume was calculated using ellipsoid volume equation: Volume =6/π×length×width×thickness. Using GA, BPD, AC, FL as independent variables and renal volume as dependent variables, the regression analyses of the mean and the standard deviation(SD) for each parameter were calculated separately. The Z-scores were calculated by the formula: Z-scores=(actual measurements of renal volume-predictive value of renal volume)/SD of predictive value.Results:Five hundred and forty-three cases of normal singleton fetuses were involved.The left and right renal volume were increased along with GA, BPD, AC, FL. Quadratic polynomial regression equations were each fitted to the models( r=0.775, 0.771, 0.811, 0.738, P<0.001; r=0.747, 0.735, 0.754, 0.745, P<0.001, respectively). The SD increased with the increases of independent variables and could be modeled with a simple linear regression( r=0.146, 0.225, 0.071, 0.155, P<0.001; r=0.091, 0.157, 0.091, 0.123, P<0.001, respectively). Z-scores were calculated and proved normally distributed after Shapiro-Wilk test( P>0.05). Conclusions:The normal Z-score reference range of fetal renal volume is established to help assess the normal renal growth and identify fetal renal abnormalities.

Objective To investigate the clinical value of prenatal diagnosis of fetal double outlet ventricle . Methods T he data of double outlet ventricle from fetal echocardiography in Second Xiangya Hospital of Central South University and Changde Women and Children Health Hospital of Hunan Province from January 2000 to August 2018 were collected . T he statistical method was used to analyze characteristics of echocardiography ,related‐intracardiac and extracardiac abnormalities ,postnatal echocardiography ,surgery and autopsy findings . Results Ninety‐four fetuses were diagnosed with double outlet ventricle ,including 84 cases of double outlet right ventricle ( DORV ) and 10 cases of double outlet left ventricle ( DOLV ) . T he pregnancy was terminated in 45 cases . Autopsy was offered to all patients after termination of pregnancy ,42 cases were consistent with prenatal diagnosis ,1 case was tetralogy of fallot ,2 cases were transposition of great artery . Forty‐nine cases were decided to continue the pregnancy ,32 cases of them were confirmed by postpartum surgery ,17 cases were confirmed by postnatal echocardiography . Echocardiographic findings of fetal double outlet ventricle was characterized by the origin of the both great arteries arising predominantly or completely( ＞50% ) from the same ventricle . Conclusions Prenatal ultrasound diagnosis of double outlet ventricular has important clinical value ,facilitate appropriate prenatal counseling and postnatal management and it should be differentiated with transposition of the great arteries ,tetralogy of fallot and ventricular septal defect .