Objective To investigate the adverse pregnancy outcomes of fetuses with increased nuchal translucency(NT).Methods A total of 376 pregnant women at the Third Affiliated Hospital of Zhengzhou University from May 2023 to January 2024 were selected as research subjects,who had a diagnosis of fetal NT ≥ the 95th percentile and complete pregnancy outcomes for singleton pregnancies.The fetuses were divided into simple thickening group(n=320)and thickening with structural abnormalities group(n=56)based on NT ultrasound results.The interventional prenatal diagnosis outcomes and pregnancy outcomes of two groups were compared.Results The rate of chromosomal abnormalities and the incidence of adverse pregnancy outcomes were higher in thickening with structural abnormalities group compared to simple thickening group with statistically significant differences(P＜0.05).The overall incidence of adverse pregnancy outcomes in NT thickened fetuses was 31.65％,but after excluding chromosomal abnormalities and structural malformations,the good pregnancy outcome rate in NT thickened fetuses was 98.09％.Conclusion NT thickening is associated with adverse pregnancy outcomes in fetuses,and the risk of poor fetal outcome is further increased when NT thickening combined with structural abnormalities in early pregnancy,but the pregnancy outcome is better in fetuses with NT thickening after excluding chromosomal abnormalities and structural malformations.

Human alphaherpesvirus 2 (HSV-2) is the main pathogen resulting human genital herpes, which poses a major threat to the socio-economic development, while there is no effective vaccine. In this study, we developed a novel lipopolyplex (LPP)-delivered mRNA vaccine expressing the HSV-2 envelope glycoprotein gD and evaluated its immunogenicity in mice. The mRNA vaccine was prepared from the genetically modified gD mRNA synthesized in vitro combined with the LPP delivery platform and it was named gD-ORI mRNA. The expression of gD antigen in the mRNA vaccine was validated in vitro by Western blotting and indirect immunofluorescence assay, then the immune responses induced by this mRNA vaccine in mice were evaluated. The immunization with gD mRNA alone induced strong humoral and cellular immune responses in mice. Robust and long-lasting gD-specific IgG antibodies were detected in the mouse serum after booster immunization with gD-ORI mRNA. The immunized mice exhibited a Th1/Th2 balanced IgG response and robust neutralizing antibodies against HSV-2, and a clear dose-response relationship was observed. The gD-specific IgG antibodies were maintained in mice for a long time, up to 18 weeks post-booster immunization. At the same time, multifunctional gD-specific CD4⁺ and CD8⁺ T cells in vaccinated mice were detected by intracellular cytokine staining (ICS). This novel gD-expressing mRNA vaccine delivered by LPP induces strong and long-lasting immune responses in mice post booster immunization and has a promising prospect for development and application. This study provides scientific evidence and reference for the development of a new mRNA vaccine for HSV-2.
Animals ; Herpesvirus 2, Human/genetics* ; Viral Envelope Proteins/genetics* ; Mice ; Herpes Genitalis/immunology* ; RNA, Messenger/immunology* ; Female ; Mice, Inbred BALB C ; Antibodies, Viral/blood* ; mRNA Vaccines/immunology* ; Antibodies, Neutralizing/blood* ; Humans

Objective To investigate the adverse pregnancy outcomes of fetuses with increased nuchal translucency(NT).Methods A total of 376 pregnant women at the Third Affiliated Hospital of Zhengzhou University from May 2023 to January 2024 were selected as research subjects,who had a diagnosis of fetal NT ≥ the 95th percentile and complete pregnancy outcomes for singleton pregnancies.The fetuses were divided into simple thickening group(n=320)and thickening with structural abnormalities group(n=56)based on NT ultrasound results.The interventional prenatal diagnosis outcomes and pregnancy outcomes of two groups were compared.Results The rate of chromosomal abnormalities and the incidence of adverse pregnancy outcomes were higher in thickening with structural abnormalities group compared to simple thickening group with statistically significant differences(P＜0.05).The overall incidence of adverse pregnancy outcomes in NT thickened fetuses was 31.65％,but after excluding chromosomal abnormalities and structural malformations,the good pregnancy outcome rate in NT thickened fetuses was 98.09％.Conclusion NT thickening is associated with adverse pregnancy outcomes in fetuses,and the risk of poor fetal outcome is further increased when NT thickening combined with structural abnormalities in early pregnancy,but the pregnancy outcome is better in fetuses with NT thickening after excluding chromosomal abnormalities and structural malformations.

OBJECTIVE To optimize the stir-frying process of Platycodon grandiflorum,compare the protective effect of P.grandiflorum on lung injury in mice before and after stir-frying,and preliminarily explore the characteristics of"enhanced efficacy through processing"of stir-frying P.grandiflorum.METHODS On the basis of single-factor experiment,the stir-frying time,temperature and frequency were taken as factors,and the comprehensive scores of appearance traits,platycodin D content and alcohol extract content were taken as indexes.Box-Behnken response surface experiment was designed to optimize the stir-frying process of P.grandiflorum and verify it.The mice were divided into blank control group,model group,dexamethasone group(positive control drug,5 mg/kg),P.grandiflorum low-dose and high-dose groups(0.6,1.2 g/kg),fried P.grandiflorum low and high dose groups(0.6,1.2 g/kg),with 8 mice in each group.The treatment was given once a day for 10 consecutive days.After the last administration,acute lung injury model was established by intratracheal instillation of lipopolysaccharide.The levels of interleukin-6(IL-6),IL-1β,tumor necrosis factor-α(TNF-α)in serum and superoxide dismutase(SOD),myeloperoxidase(MPO)and malondialdehyde(MDA)in lung tissue were detected,lung wet/dry weight ratio and thymus index were calculated,and the pathological changes of lung tissue were observed.RESULTS The optimum processing conditions were as follows:stir-frying temperature of 120℃,stir-frying time of 12 min,stir-frying frequency of 19 r/min;the comprehensive scores of the three batches of process verification were all greater than 97 points,RSD＜3%(n=3).The results of pharmacodynamic experiments showed that compared with blank control group,the lung dry-wet weight ratio as well as the levels of IL-6,IL-1β,TNF-α,MPO and MDA in the model group were significantly increased(P＜0.01),the thymus index and SOD level were significantly decreased(P＜0.01),and the lung tissue was significantly damaged.Compared with model group,above indexes of the mice in each administration group were significantly improved(P＜0.01),and the lung tissue injury was significantly reduced.At the same dose,except for the lung dry-wet weight ratio,the above indexes of the mice in the stir-fried P.grandiflorum groups were significantly improved compared with P.grandiflorum groups(P＜0.05),and the lung tissue damage was further reduced.CONCLUSIONS The optimized stir-frying process is stable and feasible.The protective effect of stir-fried P.grandiflorum on acute lung injury in mice is better than that of raw products at the same dosage.

Gastric cancer(GC)is one of the most common malignant tumors of the digestive system.Human epidermal growth factor re-ceptor 2(HER2)is an important therapeutic target in GC.In recent years,anti-HER2 agents have made significant breakthroughs in GC treat-ment,providing more options for patients.To better guide the rational,effective,and safe application of anti-HER2 therapy in clinical prac-tice,the Gastric Cancer Committee of China Anti-Cancer Association assembled domestic experts in the field of GC.After multiple rounds of discussions,they systematically reviewed domestic and international evidence-based data and integrated it with clinical practices in China.As a result,they formulated the"Chinese expert consensus on anti-HER2 therapy for gastric cancer(2024 edition)"to address the use of anti-HER2 therapy in advanced and perioperative settings,conversion therapy,and key considerations during treatment.This consensus aimed to further standardize and guide the clinical practice of anti-HER2 therapy for GC.

Gastric cancer(GC)is one of the most common malignant tumors of the digestive system.Human epidermal growth factor re-ceptor 2(HER2)is an important therapeutic target in GC.In recent years,anti-HER2 agents have made significant breakthroughs in GC treat-ment,providing more options for patients.To better guide the rational,effective,and safe application of anti-HER2 therapy in clinical prac-tice,the Gastric Cancer Committee of China Anti-Cancer Association assembled domestic experts in the field of GC.After multiple rounds of discussions,they systematically reviewed domestic and international evidence-based data and integrated it with clinical practices in China.As a result,they formulated the"Chinese expert consensus on anti-HER2 therapy for gastric cancer(2024 edition)"to address the use of anti-HER2 therapy in advanced and perioperative settings,conversion therapy,and key considerations during treatment.This consensus aimed to further standardize and guide the clinical practice of anti-HER2 therapy for GC.

OBJECTIVE: To explore the characteristics of Shwachman-Diamond syndrome (SDS) in Chinese children in order to provide a reference for early diagnosis. METHODS: With Shwachman-Diamond syndrome, SDS, SBDS gene and inherited bone marrow failure as the keywords, the search period was set from January 2002 to October 2022. Relevant literature was retrieved from the Wanfang Database and China National Knowledge Infrastructure (CNKI) database. In addition, by using Shwachman-diamond syndrome as a keyword, the search period was also retrieved from the Web of Science, PubMed, and MEDLINE databases from January 2002 to October 2022. A child with SDS treated at the Tongji Hospital was also included. A total of 44 cases with complete clinical data were analyzed with reference to the International Standard for SDS Diagnosis. Chi-square test and t test were used for statistical analysis. Evidence-based research was carried out in the form of systematic review. The epidemiology, clinical characteristics and key points of early diagnosis of the Chinese SDS children were summarized and compared with the international data. RESULTS: The main characteristics of SDS in Chinese children were summarized as follows: The ratio of males to females was about 1.3 : 1, the median age of onset was 3 months, and the median age of diagnosis was 14 months. The first symptoms were often exocrine pancreatic insufficiency (31.8%) and granulocytopenia with infection (31.8%). According to the international consensus, the incidence rates of the three major diseases of SDS were hemocytopenia (95.4%), pancreatic disease (72.7%), and bone abnormality (40.9%). The common factors underlying SDS disease were variants of the SBDS gene (c.258+2T>C and c.183_184TA>CT), albeit there was no significant correlation between genotype and phenotype (P > 0.05). Compared with international reports, the clinical manifestations and genotypes of Chinese SDS children are different (P < 0.05). CONCLUSION The SDS children have an early age of onset and significant individual difference. It is necessary to analyze the case-related data to facilitate early recognition, diagnosis and clinical intervention.
Female ; Humans ; Male ; Bone Marrow Diseases/therapy* ; China ; East Asian People ; Exocrine Pancreatic Insufficiency/therapy* ; Shwachman-Diamond Syndrome/therapy*

Objective:To analyze the clinical characteristics of hospitalized premenopausal patients with hyperuricemia.Methods:The medical records of premenopausal women with hyperuricemia (serum uric acid ≥360 μmol/L during hospitalization) admitted in Peking Union Medical College Hospital from 2013 to 2018 were reviewed and the clinical data were analyzed.Results:A total of 2 099 patients were enrolled. Only 14.01% (294 cases) of the patients were concerned about hyperuricemia by physicians. Autoimmune diseases (32.11%, 674 cases), nephrotic disease (19.29%, 405 cases) and endocrine system diseases (9.72%, 204 cases) are the main reasons for hospitalization, while 6.34%(133 cases) of patients were in gestation. In terms of the etiology, renal diseases (49.35%, 1 035 cases), specific drug use (49.26%, 1 034 cases) were the main causes of secondary hyperuricemia in premenopausal women, followed by metabolic diseases (10.62%, 233 cases). There was no significant difference in serum uric acid level among premenopausal women of different ages ( H=4.47, P=0.107), but the etiology of hyperuricemia among patients of different ages had significant differences. The proportion of hyperuricemia in patients with cancer and metabolic syndrome,secondary to use of diuretics and anti-tuberculosis drugs had differences among different age groups ( χ2=90.96,52.89,19.26 and 6.41, P<0.05). Conclusion:Hyperuricemia is not uncommon in premenopausal women. There are many secondary factors leading to hyperuricemia in premenopausal women, among which drugs and renal lesions are the main causes. In addition, the secondary factors in women with hyperuricemia has differences among different age groups.

Objective:To explore the impact of Coronavirus disease 2019 (COVID-19) epidemic on career choosing perspective among medical students and to analyze the related factors.Methods:Semi-structured telephone interviews were conducted during March 1-25 2020 among 19 medical students of 8-year program from Peking Union Medical College. The grounded theory and thematic analysis were applied to code the data and identify categories and factors.Results:Among the 19 respondents aged 19-26 years, 9 were males and 10 were female; 10 were at the clinical stage, and 9 were at the premedical stage; 3 respondents had family members involved in medical profession. Thematic analysis identified 6 main categories that affect the variability of medical students' career prospects under the COVID-19 pandemic. The 6 themes were individual characteristics of students; occupational characteristics; systemic factors; COVID-19 events; stressors of physicians and influence of job satisfaction.The outbreak affected everyone's mind of future career to varying degrees. The participants had been exposed to more negative aspects, while only one participant changed her career intention. There were conflicting views on whether to choose some specialties in future, such as respiratory medicine, infectious disease and critical care medicine. The participants feel more pressure as a doctor from the attitude of the public. Almost all participants mentioned feeling unsafe due to the high risk of occupational exposure and doctor-patient relationships. Most valued the support from their family, faculty, classmates, and volunteers. Many participants expressed their hope to improve the medical policies and systems.Conclusions:The influence of COVID-19 outbreak on medical students' career choosing can be positive as well as negative in different degrees. However, we found no evidence that it altered their perspectives substantially.

Objective To explore hemodynamic performance of the aortic dissection after lesions, so as to provide a more scientific basis for patient treatment. Methods Based on computed tomography angiography (CTA) image data from a patient with complex Stanford B-type aortic dissection, the personalized aortic dissection models with different rupture shapes (H-type, O-type, and V-type) at proximal end of the aortic dissection were established. Combined with computational fluid dynamics (CFD) and morphological analysis method, distributions of the velocity at rupture section, the blood flow, the wall pressure and the wall shear stress (WSS) were analyzed. Results The flow velocity, the highest pressure difference and the WSS proportion at entrance of the H-shaped rupture showed larger hemodynamic parameters than those of the other two types. The risk of dissection rupture for type H was the largest, while type V was in the middle, and type O was the smallest. Conclusions This study provides an effective reference for further numerical analysis the cases and formulation of treatment plans.