Objective To systematically evaluate toxicities of nifedipine in pregnant women with hypertension, and provide references for nifedipine’s clinical safety application. Methods Study was conducted with data from US food and drug administration adverse event reporting system（FARES） database from January 1, 2015, to March 31, 2021. Information component （IC） and reporting odds ratio（ROR）methods were applied for signal mining. Results Finally, a total of 539278 records of pregnant women with hypertension were selected for analysis, and 70 positive adverse drug event signals were detected. Premature delivery （IC₀₂₅=2.87，ROR₀₂₅=9.52）, pre-eclampsia （IC₀₂₅=1.82，ROR₀₂₅=3.82） and fetal growth restriction （IC₀₂₅=2.37，ROR₀₂₅=5.69）were positive adverse events with higher frequency. Polydactyly（IC₀₂₅=3.13， ROR₀₂₅=10.05）, fetal death（IC₀₂₅=2.93，ROR₀₂₅=8.57）and premature delivery（IC₀₂₅=2.87，ROR₀₂₅=9.52）were positive adverse events with higher intensity. Vascular resistance systemic increased, small for dates baby and fetal death corresponded to higher death rates. Conclusion Nifedipine-associated drug toxicities were detected in pregnant women with hypertension, and some adverse events with high frequency and high death rate were deserved further attention by medical staffs.

Single-cell analysis of phenotypic plasticity could improve the development of more effective therapeutics. Still, the development of tools to measure single-cell heterogeneity has lagged due to difficulties in manipulating and culturing single cells. Here, we describe a single-cell culture and phenotyping platform that employs a starburst microfluidic network and automatic liquid handling system to capture single cells for long-term culture and multi-dimensional analysis and quantify their clonal properties via their surface biomarker and secreted cytokine/growth factor profiles. Studies performed on this platform found that cells derived from single-cell cultures maintained phenotypic equilibria similar to their parental populations. Single-cell cultures exposed to chemotherapeutic drugs stochastically disrupted this balance to favor stem-like cells. They had enhanced expression of mRNAs and secreted factors associated with cell signaling, survival, and differentiation. This single-cell analysis approach can be extended to analyze more complex phenotypes and screen responses to therapeutic targets.

Objective To investigate the association between bone mineral density(BMD)and metabolic associated fatty liver disease(MAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 300 patients with T2DM were enrolled and divided into T2DM with MAFLD group(n=162)and T2DM without MAFLD group(n=138)according to controlled attenuation parameters(CAP).The bone mineral density(BMD)of the patients was measured by dual energy X-ray absorptiometer.Results Compared with T2DM group,BMI,abdominal circumference(AC),FIns,FC-P,TG,HOMA-IR,ALB,liver stiffness measurement(LSM),CAP and BMD in T2DM+MAFLD group increased(P<0.05),while HDL-C and alkaline phosphatase(ALP)decreased(P<0.01).Spearman correlation analysis showed that the overall BMD of the male lumbar spine was positively correlated with smoking,AC,BMI,CAP,FIns,FC-P,HOMA-IR(P<0.05 or P<0.01),and negatively correlated with ALP(P<0.01).The overall hip BMD was positively correlated with smoking,AC,BMI,CAP,FC-P(P<0.05 or P<0.01).The overall BMD of the female lumbar spine is positively correlated with BMI and CAP(P<0.05 or P<0.01),but negatively correlated with age and ALP(P<0.05 or P<0.01).The overall hip BMD was positively correlated with BMI and CAP(P<0.05),and negatively correlated with age and ALP(P<0.05 or P<0.01).Multiple linear regression analysis shows that CAP is the influencing factor for overall lumbar BMD,while BMI is the influencing factor for overall hip BMD.Conclusions CAP is the influencing factor for overall lumbar BMD,while BMI is the influencing factor for overall hip BMD.

Objective:To observe the multi-modal fundus imaging features of subretinal drusenoid deposit (SDD) in age-related macular degeneration (AMD), and observe image features.Methods:A prospective clinical study. From December 2019 to December 2023, 65 patients (104 eyes) with a diagnosis of AMD-SDD by spectral domain optical coherence tomography (SD-OCT) examination in Shandong Eye Hospital were included. All eyes were examined by best corrected visual acuity (BCVA), traditional color fundus photography (CFP), ultra-wide-angle scanning laser fundus imaging (UWF), multicolor scanning laser fundus imaging (MC) and SD-OCT. The standard MC images were obtained by using Spectralis HRA+OCT for MC examination. The multi-mode image characteristics of SDD were analyzed retrospectively. Area under curve (AUC) was used to evaluate the sensitivity and specificity of CFP, MC and UWF in detecting SDD.Results:Among 65 patients with SDD, 29 cases of males (52 eyes) and 36 cases of females (52 eyes) was included. There were 26 patients with unilateral SDD and 39 patients with bilateral SDD. The average age was (71.74±10.97) years. The early, middle and late stages of AMD were 31 (29.8%, 31/104), 24 (23.1%, 24/104), 49 (47.1%, 49/104) eyes, respectively. The SDD detected by CFP, MC and UWF was 76 (73.1%, 76/104), 94 (90.4%, 94/104), 96 (92.3%, 96/104) eyes. CFP showed that the edge of SDD in the macular area was blurred. UWF showed that the dot and the ribbon SDD were light yellow pale discrete deposits and light yellow interlaced network deposits respectively. MC showed the dot SDD had a strong yellow-green circular reflection, while the edge of the ribbon SDD was surrounded by a weak reflection, and the boundary was clear. SD-OCT showed that SDD had strong reflection signal, which was located between the retinal pigment epithelium layer and the photoreceptor cell layer. The dot SDD could break through the ellipsoid zone and caused slight uplift or interruption of the external membrane, showing a cone-like strong reflection signal. While the ribbon SDD showed a continuous "hill-like" protrusion, which hardly broke through ellipsoid zone. The sensitivity and specificity of CFP, MC and UWF for SDD were 73.1%, 90.4%, 92.3% and 61.1%, 94.4% and 83.3%, respectively.Conclusions:MC and UWF show high sensitivity and specificity in diagnosing AMD-SDD, which is superior to CFP. SD-OCT can effectively reveal the location and morphoLogical characteristics of SDD under retina.

Purpose To analyze the imaging features of juvenile xanthogranuloma (JXG) in children and to improve the diagnostic level of JXG. Materials and Methods The clinical and imaging data of 15 children with JXG confirmed by menstrual biopsy or surgical pathology from January 2011 to December 2023 in Hunan Children's Hospital were retrospectively analyzed. 13 cases underwent CT examinations and 7 cases underwent MRI examinations,of which 5 underwent both MRI and CT examinations. The type,number,involved site,lesion signal,density and enhancement characteristics of JXG were observed and analyzed. Results Of the 15 children with JXG,7 cases were systemic. It involves the central nervous system (5 cases,including pineal region,choroid plexus,cranial sublamina,middle cranial fossa and spinal canal),mastoid process (1 case),liver (3 cases),kidney (3 cases),pancreas (1 case) and lung (2 cases),mainly manifested as single or multiple nodular,mass or patchy lesions in different organs. On MRI,the lesions showed slightly higher or lower or mixed signals on T1WI,low/slightly lower or higher or mixed signals on T2WI,unrestricted or limited diffusion,and significantly enhanced or slightly enhanced enhancement. On CT,the lesions showed patchy,clumpy or nodular low-density or high-density shadows,and the enhancement was mild to moderate uneven enhancement or obvious enhancement. 8 patients with simple skin type showed nodular shadow of subcutaneous soft tissue,equal or slightly low signal on T1WI,slightly low/low signal on T2WI and obvious enhancement. CT showed a slightly low/equal/slightly high density image,and the enhancement showed a slightly enhanced/significantly enhanced image. Conclusion JXG mainly presents as single or multiple nodules and clumps in subcutaneous soft tissues and/or various organs,with increased signal on T1WI,decreased signal on T2WI,decreased or increased diffusion and obvious enhancement. The CT and MRI manifestations of JXG have certain characteristics.

Purpose To analyze the imaging features of juvenile xanthogranuloma (JXG) in children and to improve the diagnostic level of JXG. Materials and Methods The clinical and imaging data of 15 children with JXG confirmed by menstrual biopsy or surgical pathology from January 2011 to December 2023 in Hunan Children's Hospital were retrospectively analyzed. 13 cases underwent CT examinations and 7 cases underwent MRI examinations,of which 5 underwent both MRI and CT examinations. The type,number,involved site,lesion signal,density and enhancement characteristics of JXG were observed and analyzed. Results Of the 15 children with JXG,7 cases were systemic. It involves the central nervous system (5 cases,including pineal region,choroid plexus,cranial sublamina,middle cranial fossa and spinal canal),mastoid process (1 case),liver (3 cases),kidney (3 cases),pancreas (1 case) and lung (2 cases),mainly manifested as single or multiple nodular,mass or patchy lesions in different organs. On MRI,the lesions showed slightly higher or lower or mixed signals on T1WI,low/slightly lower or higher or mixed signals on T2WI,unrestricted or limited diffusion,and significantly enhanced or slightly enhanced enhancement. On CT,the lesions showed patchy,clumpy or nodular low-density or high-density shadows,and the enhancement was mild to moderate uneven enhancement or obvious enhancement. 8 patients with simple skin type showed nodular shadow of subcutaneous soft tissue,equal or slightly low signal on T1WI,slightly low/low signal on T2WI and obvious enhancement. CT showed a slightly low/equal/slightly high density image,and the enhancement showed a slightly enhanced/significantly enhanced image. Conclusion JXG mainly presents as single or multiple nodules and clumps in subcutaneous soft tissues and/or various organs,with increased signal on T1WI,decreased signal on T2WI,decreased or increased diffusion and obvious enhancement. The CT and MRI manifestations of JXG have certain characteristics.

OBJECTIVE: To explore the genetic mechanism underlying a case with para-Bombay phenotype. METHODS: The ABO and Lewis phenotype were identified with serological methods. The coding regions of exons 6 and 7 of the ABO and FUT1 genes were amplified with PCR and directly sequenced. Haploid sequence analysis was carried out on the variant sites of the FUT1 gene. RESULTS: Serological analysis confirmed that the proband has a rare para-Bombay phenotype. Direct sequencing revealed that he was a B.01/O.01.02 heterozygote for the ABO gene, and had heterozygous deletion for the 768 and 881-882 sites of the FUT1 gene. Further haploid analysis showed that the c.881_882delTT deletion has occurred in one haploid while c.768delC was present in the other haploid. The proband was therefore determined as a FUT1*01N.13/01N.20 heterozygote, which have resulted in frameshift in polypeptide chain p.Phe294Cysfs*40 and p.Val257Phefs*23, respectively. CONCLUSION A rare bi-allelic heterozygous deletion of para-Bombay phenotype has been identified in a blood donor. The c.881_882delTT and c.768delC deletions may decrease the activity of α-1,2-fucosyltransferase.
Animals ; Male ; ABO Blood-Group System/genetics* ; Alleles ; Fucosyltransferases/genetics* ; Genotype ; Heterozygote ; Mutation ; Phenotype ; Humans

Based on the latest results of international researches, combining with the experiences of our team in the simulation of acute dyspnea, Xiangya Hospital Central South University has summarized 7 characteristics, procedures and methods of debriefing, including that immediate feedback happens after simulation; feedback is provided by a trained instructor with clinical experience; feedback time is at least longer than the simulation time; various international methods of feedback can be used; the content of feedback is the learning objective; oral feedback is preferred; video can be used to review the details. The study aims to provide a theoretical basis for debriefing in domestic scenario stimulation teaching, and finally improve the effectiveness of the scenario stimulation teaching.

OBJECTIVE: To investigate the change of pulmonary ventilation function in patients with simple type and complex type pneumoconiosis based on high resolution computed tomography(HRCT). METHODS: A total of 188 male patients with pneumoconiosis were selected as the study subjects by judgment sampling method. Patients were divided them into simple type group(104 cases) and complex type group(84 cases) according to their chest HRCT findings. Another 80 healthy men who have no dust and other occupational hazard exposure were selected as the control group. The lung function tests were performed in patients in these three groups. RESULTS: The indexes of pulmonary function including vital capacity, forced vital capacity(FVC), forced expiratory volume in one second(FEV_1), FEV_1/FVC%, peak expiratory flow, forced expiratory flow at 25% of FVC exhaled, forced expiratory flow at 50% of FVC exhaled, forced expiratory flow at 75% of FVC exhaled and forced expiratory flow at 25% to 75% of vital capacity were lower in patients with pneumoconiosis of simple type and complex type groups than that in the control group(all P<0.01). The above indexes in the complex type group were lower than that in the simple type group(all P<0.01). The detection rate of pulmonary ventilation dysfunction in patients with pneumoconiosis was 64.9%. Among them, the detection rate of obstructive, restrictive and mixed ventilation dysfunction were 33.5%, 5.3% and 26.1%, respectively. The detection rates of pulmonary ventilation dysfunction and mixed ventilation dysfunction were higher in complex type group than that in simple type group(82.1% vs 51.0%, 41.7% vs 13.5%, all P<0.01). The severe and extremely severe pulmonary ventilation dysfunction was higher in complex type group than that in simple group(20.2% vs 8.6%, 21.4% vs 3.8%, all P<0.05). CONCLUSION: The types of pulmonary ventilation dysfunction in patients with pneumoconiosis are mainly obstructive and mixed. The pulmonary ventilation dysfunction tends to develop from obstructive to mixed with the increasing severity of pneumoconiosis. The pulmonary ventilation dysfunction in patients with complex type pneumoconiosis is more serious than that in patients with simple type pneumoconiosis. The HRCT image classification is related to the status of patients' pulmonary ventilation dysfunction.

Objective:To summarize the experience of five hospitals in Guangdong Province on successfully transporting retained passengers by chartered flights during the outbreak of the COVID-19.Methods:We retrospectively evaluated the operation and management, cabin arrangement, isolation requirements, and personnel protection in the aspect of epidemic prevention and control.Results:In 11 charter missions, over one thousand "healthy" passengers with potential risk of infections were transported back to China. The medical delivery team and flight crew were kept free of infection, passengers maintained zero cluster infections and no unexpected adverse events during the air transport.Conclusions:Our results indicate how to carry passengers in a scientific and orderly way is crucial for avoiding the transmission risks of the epidemic of COVID-19 among working staffers and passengers during air transportation.