Objective:To measure the distance between the fetal bladder neck and the rectal end using prenatal MRI and analyze the developmental patterns of this distance and the gender differences in the second and third trimesters of pregnancy.Methods:This retrospective cohort study involved fetuses born at Guangzhou Women and Children's Medical Center, Guangzhou Medical University after regular prenatal examinations from January 2019 to December 2022 and confirmed to have typical anorectal structures after birth. These fetuses had undergone prenatal MRI examinations for reasons other than abdominal issues. The morphology of the fetuses' colons, rectums, and bladders was observed, and the vertical distance between the bladder neck and the rectal end was measured on sagittal T1weighted imaging. Differences in the distance between male and female fetuses were analyzed. The fetuses were divided into five groups based on their gestational age at the time of MRI examination (23-24 weeks, >24-26 weeks, >26-28 weeks, >28- 30 weeks, and >30-32 weeks), and the changes in the distance with gestational age were analyzed. Statistical analysis was performed using t-test, Kruskal-Wallis test, and Spearman correlation analysis. Pairwise comparisons among multiple groups were conducted using the Bonferroni method. Results:(1) A total of 142 fetuses were included in this study, all of which were singletons, with 73 males (51.4%) and 69 females (48.6%). The gestational age at the MRI examination was 28 weeks (26-30 weeks). (2) All fetuses had meconium filling the entire rectum and colon, with the rectal end located 0.570-2.610 cm below the bladder neck. (3) The distance between the bladder neck and the rectal end was shorter in male fetuses than in female fetuses [(1.140±0.261) vs. (1.519±0.405) cm, t=－6.58, P<0.001]. (4) In female fetuses, four pairs of groups showed statistically significant differences in the distance (23-24 weeks group vs. >26-28 weeks, >28- 30 weeks, and >30-32 weeks groups, and >24-26 weeks group vs. >30-32 weeks group). However, only two groups of male fetuses (23-24 weeks group vs. >28-30 weeks group) had statistically significant differences in the distance (all P<0.005). (5) The distance was moderately correlated with gestational age in male fetuses ( r=0.42, P<0.001), but they were strongly correlated in female fetuses ( r=0.66, P<0.001). Conclusions:The distance between the bladder neck and the rectal end in fetuses shows certain developmental patterns and gender differences in pregnancy's second and third trimesters. The correlation between the value and gestational age is stronger in female fetuses.

Objective:To measure the distance between the fetal bladder neck and the rectal end using prenatal MRI and analyze the developmental patterns of this distance and the gender differences in the second and third trimesters of pregnancy.Methods:This retrospective cohort study involved fetuses born at Guangzhou Women and Children's Medical Center, Guangzhou Medical University after regular prenatal examinations from January 2019 to December 2022 and confirmed to have typical anorectal structures after birth. These fetuses had undergone prenatal MRI examinations for reasons other than abdominal issues. The morphology of the fetuses' colons, rectums, and bladders was observed, and the vertical distance between the bladder neck and the rectal end was measured on sagittal T1weighted imaging. Differences in the distance between male and female fetuses were analyzed. The fetuses were divided into five groups based on their gestational age at the time of MRI examination (23-24 weeks, >24-26 weeks, >26-28 weeks, >28- 30 weeks, and >30-32 weeks), and the changes in the distance with gestational age were analyzed. Statistical analysis was performed using t-test, Kruskal-Wallis test, and Spearman correlation analysis. Pairwise comparisons among multiple groups were conducted using the Bonferroni method. Results:(1) A total of 142 fetuses were included in this study, all of which were singletons, with 73 males (51.4%) and 69 females (48.6%). The gestational age at the MRI examination was 28 weeks (26-30 weeks). (2) All fetuses had meconium filling the entire rectum and colon, with the rectal end located 0.570-2.610 cm below the bladder neck. (3) The distance between the bladder neck and the rectal end was shorter in male fetuses than in female fetuses [(1.140±0.261) vs. (1.519±0.405) cm, t=－6.58, P<0.001]. (4) In female fetuses, four pairs of groups showed statistically significant differences in the distance (23-24 weeks group vs. >26-28 weeks, >28- 30 weeks, and >30-32 weeks groups, and >24-26 weeks group vs. >30-32 weeks group). However, only two groups of male fetuses (23-24 weeks group vs. >28-30 weeks group) had statistically significant differences in the distance (all P<0.005). (5) The distance was moderately correlated with gestational age in male fetuses ( r=0.42, P<0.001), but they were strongly correlated in female fetuses ( r=0.66, P<0.001). Conclusions:The distance between the bladder neck and the rectal end in fetuses shows certain developmental patterns and gender differences in pregnancy's second and third trimesters. The correlation between the value and gestational age is stronger in female fetuses.

A 3-year-old girl was hospitalized for cough and asthma for 2 days, and fever and anuria for 1 day in Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in January 2019.Retrospective analysis was used.She developed end-stage renal disease and received peritoneal dialysis 6 months ago.After admission, she was diagnosed as acute-on-chronic renal failure, respiratory failure, heart failure, severe influenza A (H1N1). The patient was rapidly recovered by the management of high-volume peritoneal dialysis, mechanical ventilation, and medications of Peramivir and Methylprednisolone.Through literature review, case report or cohort study about the treatment of acute kidney disease by high-volume peritoneal dialysis has not been previously reported.This case report suggested that high-volume peritoneal dialysis is able to effectively remove solutes and control volume without causing severe hypoproteinemia and hyperglycemia, which may become an effective renal replacement therapy for children with multi-organ dysfunction syndrome.

Objective:To evaluate the teaching effectiveness of independent experimental design from students' active learning behavior, and further provide the basis for advancing the reform of functional experimental teaching and teaching quality.Methods:In June 2019, 186 undergraduates (5-year-programme and 8-year-programme) of Xiangya School of Medicine were included in the teaching research. Self-administered questionnaires were applied to characterize students' active learning behavior in independent experimental design education. Spearman rank correlation analysis and Logistic regression analysis were used in the study. SPSS 23.0 was used for descriptive analysis of the data.Results:During the independent experimental design, 85.0%(158/186) of the students thought it was necessary and important to conduct independent experimental design education; 72.6%(135/186) of the students tentatively raised new scientific questions; 97.8%(182/186) of the students actively searched literature; 77.4%(144/186) of the students participated in reply positively. The value of correlation coefficient of actively learning behavior "tentatively raising new science questions" and teaching effectiveness "improving the ability of scientific thinking" was 0.81. And only 42.5%(79/186) of the students agreed that students needed to summarize after reporting.Conclusion:Independent experimental design education is welcomed and widely accepted by students, which has effectively improved the capacity for scientific research and innovation spirit of students. Whether students' active learning behavior can be fully mobilized in the education practice is closely related to the teaching effect. And the cultivation of leadership and leading consciousness still need to be improved.

Nonalcoholic fatty liver disease is a common chronic liver disease with the risk of progression to nonalcoholic hepatitis, liver fibrosis, and hepatocellular carcinoma. Nonalcoholic fatty liver disease has various pathogeneses, among which abnormal metabolism of branched-chain amino acids can induce oxidative stress, autophagy, and mitochondrial dysfunction in hepatocytes and is the most important mechanism in the development and progression of nonalcoholic fatty liver disease. This article reviews related research advances and analyzes the possible role of abnormal metabolism of branched-chain amino acids in the development and progression of nonalcoholic fatty liver disease, in order to improve clinical awareness and diagnosis.

Objective:To investigate the role and significance of heme oxygenase-1 (HO-1) in regulating macrophage polarization on seawater-drowning-induced acute lung injury (ALI) in mice.Methods:Raw 264.7 cells were divided into four groups. The control group was not stimulated with artificial seawater (SW), while the SW 8 h group, SW 24 h group, and SW 72 h group stimulated with artificial seawater for 8 h, 24 h, and 72 h, respectively. The morphological changes of cells were observed, the apoptosis, the contents of inducible nitric oxide synthase (iNOS), and HO-1 protein were detected. Hmox1 flox/ floxCre+ /- and Hmox1 -/- (HO-1 M-KO) mice with conditional knockout of HO-1 gene in alveolar macrophages were produced and randomly divided into HO-1 flox/flox Control group, HO-1 flox/flox SW 24 h group, HO-1 M-KO Control group, and HO-1 M-KO SW 24 h Group, with 6 mice in each group. The mouse model of seawater-drowning-induced ALI was established by placing mice in a hollow container and then immersing them in 6 cm deep and (25±2)℃ artificial seawater for 28 s. Samples were taken 24 hours after seawater drowning to carry out alveolar lavage, and then the total cell counts and protein concentrations in bronchoalveolar lavage fluid (BALF), and the pathological changes and the iNOS protein content in lung tissues were observed. Results:Abnormally shaped Raw 264.7 cells increased while the total number of Raw 264.7 cells decreased after seawater stimulation. The apoptosis rates of the control group, SW 8 h group, SW 24 h group, and SW 72 h group were increased to (5.99±0.23)%, (16.71±1.16)%, (41.80±2.50)%, and (77.84±1.59)%, respectively, with statistically significant differences ( P<0.01). The contents of HO-1 protein in the control group, SW 8 h group, SW 24 h group, and SW 72 h group were (1.07±0.06), (1.42±0.01), (2.77±0.22), and (0.99±0.10), respectively, and the contents of HO-1 protein of both SW 8 h group and SW 24 h group increased significantly ( P<0.05). The contents of iNOS protein in the cells of the control group, SW 8 h group, SW 24 h group, and SW 72 h group were (0.94±0.10), (3.44±0.32), (1.52±0.09), and (2.26±0.11), respectively, and the contents of iNOS protein of SW 8 h group, SW 24 h group, and SW 72 h group increased significantly ( P<0.05); compared with the SW 8 h group, the HO-1 protein content increased significantly, while the iNOS protein content decreased in the SW 24 h group significantly ( P<0.01). Lung tissue injury in HO-1 M-KO mice was significantly aggravated after drowning. The cavity of pulmonary alveoli collapsed and shrunk, intra-alveolar hemorrhage occurred, alveolar septum thickened, and inflammatory cell infiltration aggravated. The cell number and protein concentration in BALF significantly increased ( P<0.01), and the iNOS content in lung tissue significantly increased( P<0.01). Conclusion:HO-1 can alleviate the seawater-drowning-induced ALI in mice by inhibiting the M1 macrophage polarization.

Objective:To investigate the role and significance of heme oxygenase-1 (HO-1) in regulating macrophage polarization on seawater-drowning-induced acute lung injury (ALI) in mice.Methods:Raw 264.7 cells were divided into four groups. The control group was not stimulated with artificial seawater (SW), while the SW 8 h group, SW 24 h group, and SW 72 h group stimulated with artificial seawater for 8 h, 24 h, and 72 h, respectively. The morphological changes of cells were observed, the apoptosis, the contents of inducible nitric oxide synthase (iNOS), and HO-1 protein were detected. Hmox1 flox/ floxCre+ /- and Hmox1 -/- (HO-1 M-KO) mice with conditional knockout of HO-1 gene in alveolar macrophages were produced and randomly divided into HO-1 flox/flox Control group, HO-1 flox/flox SW 24 h group, HO-1 M-KO Control group, and HO-1 M-KO SW 24 h Group, with 6 mice in each group. The mouse model of seawater-drowning-induced ALI was established by placing mice in a hollow container and then immersing them in 6 cm deep and (25±2)℃ artificial seawater for 28 s. Samples were taken 24 hours after seawater drowning to carry out alveolar lavage, and then the total cell counts and protein concentrations in bronchoalveolar lavage fluid (BALF), and the pathological changes and the iNOS protein content in lung tissues were observed. Results:Abnormally shaped Raw 264.7 cells increased while the total number of Raw 264.7 cells decreased after seawater stimulation. The apoptosis rates of the control group, SW 8 h group, SW 24 h group, and SW 72 h group were increased to (5.99±0.23)%, (16.71±1.16)%, (41.80±2.50)%, and (77.84±1.59)%, respectively, with statistically significant differences ( P<0.01). The contents of HO-1 protein in the control group, SW 8 h group, SW 24 h group, and SW 72 h group were (1.07±0.06), (1.42±0.01), (2.77±0.22), and (0.99±0.10), respectively, and the contents of HO-1 protein of both SW 8 h group and SW 24 h group increased significantly ( P<0.05). The contents of iNOS protein in the cells of the control group, SW 8 h group, SW 24 h group, and SW 72 h group were (0.94±0.10), (3.44±0.32), (1.52±0.09), and (2.26±0.11), respectively, and the contents of iNOS protein of SW 8 h group, SW 24 h group, and SW 72 h group increased significantly ( P<0.05); compared with the SW 8 h group, the HO-1 protein content increased significantly, while the iNOS protein content decreased in the SW 24 h group significantly ( P<0.01). Lung tissue injury in HO-1 M-KO mice was significantly aggravated after drowning. The cavity of pulmonary alveoli collapsed and shrunk, intra-alveolar hemorrhage occurred, alveolar septum thickened, and inflammatory cell infiltration aggravated. The cell number and protein concentration in BALF significantly increased ( P<0.01), and the iNOS content in lung tissue significantly increased( P<0.01). Conclusion:HO-1 can alleviate the seawater-drowning-induced ALI in mice by inhibiting the M1 macrophage polarization.

Objective:To evaluate the value of MRI in the diagnosis of jejunal and ileal atresia in fetus.Methods:This study included thirteen neonates with surgically and pathologically confirmed jejunal or ileal atresia without other gastrointestinal diseases treated in our institution between January 1, 2010 and December 31, 2018. MRI was performed on all fetuses subsequent to routine prenatal sonographic examinations indicated bowel dilation or ascites. MR images were analyzed by two radiologists,and MRI diagnosis was compared with surgical and pathological results.Results:On prenatal MRI, eight fetuses exhibited single or multiple dilated small bowel loops, one of them exhibited a cystic mass in the abdomen; five fetuses exhibited massive ascites, and collected bowels. On final surgical and pathological diagnosis, nine fetuses had ileal atresia, five of them had intestinal perforation; four fetuses had jejunal atresia, one of them had intestinal perforation and a meconium pseudocyst. Among the 7 cases without intestinal perforation, the atresia location was diagnosed correctly in 5 cases. The 6 fetuses with intestinal perforation were diagnosed as intestinal atresia and meconium peritonitis by prenatal MRI, but the location of atresia could not be determined.Conclusions:Jejunal and ileal atresia have their characteristic manifestations on prenatal MRI. The location of atresia can be inferred from the distribution of amniotic fluid and meconium in the intestine. Prenatal MRI has a complementary role in the assessment of fetal bowel abnormalities after standard obstetric ultrasound.

Objective:To investigate the role of NF-E2-related factor 2 (Nrf2) in lung injury caused by seawater drowning in mice.Methods:A total of 48 6-8 weeks old male wild-type C57 mice were randomly divided into two groups for experiment: (1) control group, day 1 group after drowning(Day1), day 3 group after drowning(Day3) and day 7 group after drowning(Day7) to determine the time point of seawater drowning; (2) control group, seawater drowning model group(SW), dimethyl fumarate treatment group(DMF) and seawater drowning+ DMF reatment group(SW+ DMF) to determine the role of Nrf2 in lung injury in mice caused by drowning, 6 mice per group. And 12 male C57 background Nrf2 knockout mice (Nrf2 KO) at 6-8 weeks old were divided into Nrf2 KO control group and Nrf2 KO+ seawater drowning group; 6 mice in each group. Three days after the drowning model was established, we observed the gross morphology and the pathological changes of the lung tissue, calculated the wet-to-dry weight ratio of the lungs, and tested the reduced glutathione and malondialdehyde levels.Results:Seawater drowning caused alveolar space rupture, pulmonary hemorrhage and pulmonary edema in mice. Compared with the wild-type mice, knockout of Nrf2 aggravated lung injury and oxidative stress in mice caused by seawater drowning. Nrf2 agonist DMF treatment significantly improved lung injury in mice, increased the reduced glutathione content, and decreased malondialdehyde level.Conclusion:The activation of Nrf2 can relieve lung injury and oxidative stress levels in mice caused by seawater drowning, which can play an important role in reducing lung damage caused by seawater drowning.

Objective:To investigate the role of NF-E2-related factor 2 (Nrf2) in lung injury caused by seawater drowning in mice.Methods:A total of 48 6-8 weeks old male wild-type C57 mice were randomly divided into two groups for experiment: (1) control group, day 1 group after drowning(Day1), day 3 group after drowning(Day3) and day 7 group after drowning(Day7) to determine the time point of seawater drowning; (2) control group, seawater drowning model group(SW), dimethyl fumarate treatment group(DMF) and seawater drowning+ DMF reatment group(SW+ DMF) to determine the role of Nrf2 in lung injury in mice caused by drowning, 6 mice per group. And 12 male C57 background Nrf2 knockout mice (Nrf2 KO) at 6-8 weeks old were divided into Nrf2 KO control group and Nrf2 KO+ seawater drowning group; 6 mice in each group. Three days after the drowning model was established, we observed the gross morphology and the pathological changes of the lung tissue, calculated the wet-to-dry weight ratio of the lungs, and tested the reduced glutathione and malondialdehyde levels.Results:Seawater drowning caused alveolar space rupture, pulmonary hemorrhage and pulmonary edema in mice. Compared with the wild-type mice, knockout of Nrf2 aggravated lung injury and oxidative stress in mice caused by seawater drowning. Nrf2 agonist DMF treatment significantly improved lung injury in mice, increased the reduced glutathione content, and decreased malondialdehyde level.Conclusion:The activation of Nrf2 can relieve lung injury and oxidative stress levels in mice caused by seawater drowning, which can play an important role in reducing lung damage caused by seawater drowning.