Objective To observe the value of ovarian-adnexal reporting and data system ultrasound 2022 version(O-RADS US v2022)and it combined with risk of malignancy index 4(RMI4)for differential diagnosis of benign and malignant adnexal tumors.Methods Data of 126 patients with adnexal tumors confirmed by surgical pathology were retrospectively analyzed.O-RADS US v2022 was used to classify:1-3 as benign lesion and 4-5 as malignant lesion.RMI4 classification took 450 as the critical value.And classification was performed based on the two combination.Taking pathological results as gold standard,receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of O-RADS US v2022 and RMI4 alone or combination for the differential diagnosis of benign and malignant adnexal tumors.Results Among 126 cases,94 were benign and 32 were malignant tumors.The sensitivity,specificity,accuracy and area under the curve(AUC)of O-RADS US v2022 were 78.13％,80.85％,80.16％and 0.795,respectively.The diagnostic results of RMI4 were 71.88％,84.04％,80.95％and 0.780,respectively.The specificity and accuracy of the combination of the two(93.62％,92.06％)were higher than those of O-RADS US v2022(x2=7.322,5.967,P=0.007,0.015)or RMI4(x2=4.625,5.331,P=0.032,0.021),while no significant difference in sensitivity and AUC(87.50％,0.906)was found with O-RADS US v2022 or RMI4(all P＞0.05).Conclusion O-RADS US v2022 could effectively differentiate benign and malignant adnexal tumors,and combined with RMI4 could improve the diagnostic specificity and accuracy.

Objective:To analyze the distribution characteristics of UGT1A1 mutant genes (including enhancers, promoters, and exons 1-5) and further explore the correlation between UGT1A1 genotype and clinical phenotypes in patients with inherited hyperunconjugated bilirubinemia.Methods:Patients diagnosed with hereditary hyperunconjugated bilirubinemia at Nanjing Second Hospital from June 2015 to December 2022 were retrospectively analyzed. The UGT1A1 gene was examined using Sanger sequencing in all patients. Complete blood count, liver function, and abdominal imaging examinations were performed. Comparison of categorical variable data using χ2 testor Fisher percision tests. Comparison of continaous veriable data with normal distribution using t-test. Results:112 cases (male:female ratio 81:31, aged 9-70 years) had inherited hyperunconjugated bilirubinemia, with a total of 14 mutation sites identified, of which seven were confirmed mutations, and the frequency ranged from high to low: (TA)n accounted for 50%, c.211G>A (p.G71R) accounted for 49.10%, 1456T>G (p.Y486D) accounted for 16.96%, c.686C>A (p.R229W) accounted for 12.5%, 1091C>T (p.P364L) accounted for 8.04%, and c- 3279T>G accounted for 0.982%. Simultaneously, all patients had one to four mutations, of which only one mutation was the most common (55.36%), followed by two mutations (37.5%), and rare three and four mutations (5.36% and 1.78%). There was no statistical significance in total bilirubin (TBil) levels among the four groups ( F=0.652, P=0.583). One mutation was most common in (TA)n and c.211G>A (p.G71R), among which TA6/TA7 ( n=10) and TA7/TA7 ( n=14) mutations were statistically significant in TBil ( t=2.143, P=0.043). The c.211G>A (p.G71R) heterozygous ( n=9) and isolated ( n=15) mutation had no statistical significance in TBil ( t=0.382, P=0.706). The GS group accounted for 75%, the intermediate group accounted for 16.9%, and the CNS-Ⅱ group accounted for 8%. TBil was statistically significant among the three groups ( F=270.992, P<0.001). There was no statistically significant difference ( χ2=3.317, P=0.19) between mutation 1 (44 cases, 14 cases, and 4 cases, respectively) and mutations ≥ 2 (40 cases, 5 cases, and 5 cases, respectively) in the GS group, intermediate group, and CNS-II group. Conclusion:The number of UGT1A1 gene mutation sites may have no synergistic effect on TBil levels in patients with inherited hyperunconjugated bilirubinemia. TA7/TA7 mutations are not uncommon, and TBil levels are relatively high.

Objective To investigate the correlation between non-alcoholic fatty liver disease(NAFLD)and coronary artery plaque and perivascular adipose tissue(PVAT)parameters.Methods A total of 119 patients who underwent liver ultrasound and coronary computed tomography angiography(CCTA)examination were selected and divided into NAFLD group(50 cases)and non-NAFLD group(69 cases).The types of coronary artery plaque,plaque vulnerability,plaque involvement length,plaque load,vascular remode-ling,degree of vessel stenosis,and parameters of pericoronary fat[pericoronary fat attenuation index(pFAI),pericoronary fat total volume of voxels(pFV),perivascular water attenuation index(PVWI)]were evaluated.The data were analyzed statistically.Results The incidence of vulnerable plaque in NAFLD group was higher than that in non-NAFLD group,and the difference was statistically significant(P＜0.001).The incidence of positive vascular remodeling in NAFLD group was higher than that in non-NAFLD group,the incidence of no remodeling was the opposite,and the differences were statistically significant(P=0.001).The incidence of non-calcified plaque in NAFLD group was higher than that in non-NAFLD group,and the incidence of calcified plaque was the opposite(P=0.011).The incidence of severe stenosis in NAFLD group was higher than that in non-NAFLD group,and the incidence of moderate stenosis was the opposite,with statistical significance(P=0.004).The pFAI and plaque load in NAFLD group was higher than that in non-NAFLD group,and the pFV value was lower than that in non-NAFLD group,with statistical significance(P＜0.001,P=0.029,P=0.002).Conclusion The incidences of vulnerable plaque,positive remodeling,non-calcified plaque,vascular severe stenosis,and plaque load are significantly higher in NAFLD group than those in non-NAFLD group.In addition,pFAI increases and pFV decreases in NAFLD group.

Plasticity in the glutamatergic synapses on striatal medium spiny neurons (MSNs) is not only essential for behavioral adaptation but also extremely vulnerable to drugs of abuse. Modulation on these synapses by even a single exposure to an addictive drug may interfere with the plasticity required by behavioral learning and thus produce impairment. In the present work, we found that the negative reinforcement learning, escaping mild foot-shocks by correct nose-poking, was impaired by a single in vivo exposure to 20 mg/kg cocaine 24 h before the learning in mice. Either a single exposure to cocaine or reinforcement learning potentiates the glutamatergic synapses on MSNs expressing the striatal dopamine 1 (D1) receptor (D1-MSNs). However, 24 h after the cocaine exposure, the potentiation required for reinforcement learning was disrupted. Specific manipulation of the activity of striatal D1-MSNs in D1-cre mice demonstrated that activation of these MSNs impaired reinforcement learning in normal D1-cre mice, but inhibition of these neurons reversed the reinforcement learning impairment induced by cocaine. The results suggest that cocaine potentiates the activity of direct pathway neurons in the dorsomedial striatum and this potentiation might disrupt the potentiation produced during and required for reinforcement learning.

Objective: To investigate the prevalence of witnessing domestic violence,and to explore the relationship between witness domestic violence in childhood and college students’ injury and violence behaviors. Methods: In October 2018, self-made questionnaire on “Health and Risky Behaviors among University Students in Anhui Province” was conducted among 4 034 college students from 4 universities in Hefei. Multivariate Logistic regression models (control of confounding factors) were used to explore the impact of childhood witnessing domestic violence on college students’ injury and violence. Results: Among 4 034 college students,the prevalence of witnessing domestic emotional violence,mild physical violence and severe physical violence in childhood was 27.6%,22.4%,10.7%,respectively. Univariate analysis showed that students with experiences of witness domestic emotional violence,mild physical violence and severe physical violence had higher rates of self-injury,physical,emotional,and sexual violence compared to those without domestic violence witness(P<0.05). Multivariate Logistic regression analysis showed that witnessing domestic severe physical violence,emotional violence in childhood associated positively with self-harm (OR=1.53,95%CI=1.05-2.23; OR=2.15,95%CI=1.51-3.04) and emotional violence (OR=1.65,95%CI=1.16-2.35; OR=2.57,95%CI=1.87-3.53). Witnessing domestic severe physical violence showed positive association with physical violence (OR=4.99,95%CI=2.58-9.62) and sexual violence (OR=8.68,95%CI=3.30-22.81) among college students (P<0.05). Conclusion The experiences of witness domestic violence can increases the risk of college student’s injury and violence behaviors,especially witness domestic severe physical violence.

The clinical data of 31 patients with congenital heart disease(CHD)receiving minimally invasive surgical closure through chest or femoral venous catheter from June 2016 to September 2017 were analyzed retrospectively.All patients were diagnosed with esophageal echocardiography before operation.During the operation,the insert of guide wire and the sheath tube,and the placement of the sealing parasol were monitored and guided by transesophageal echocardiography (TEE).Satisfactory results were obtained in 30 patients.In 1 patients,the sealing parasol was detached,and open chest surgery was performed to remove the detached parasol and to repair the defect.TEE-guided minimally invasive surgical closure through chest or femoral vein catheter is safe and effective in the treatment of congenital heart disease and has certain clinical applicative value.

Objective: To investigate the clinical value of TEE-guided interventional occlusion for treating congenital heart disease (CHD). Methods: Clinical data of 50 CHD patients who underwent TEE-guided minimally invasive closure were analyzed retrospectively. There were 29 cases of ventricular septal defect (VSD), 12 cases of atrial septal defect (ASD), 1 case of ASD combined with VSD and 8 cases of patent ductus arteriosus (PDA). The interventional occlusions were performed through transthoracic approach. Before occlusion, TEE was used to diagnose and observe the heart defect again, while intraoperative TEE was used for real-time monitoring and guiding the wire and sheath aimed to the designated position and occlusion umbrella placement. Postoperative TEE was also performed to evaluate the occlusion effect. Electrocardiogram was used to monitor the arrhythmia and conduction block of patients. Results: Interventional occlusions were successfully performed in 49 cases under the guidance of TEE. Remaining shunts were found in 11 patients with TEE immediately after interventional occlusion. TEE reexamined at 1, 3 and 6 months after operation showed satisfied occluder position in all 49 patients. Neither residual shunt nor valve regurgitation caused by occlusion was found. And there was no arrhythmia and conduction block detected with ECG. The occlusion of VSD failed in 1 patient. Conclusion: TEE is a safe, effective, minimally invasive, radiation-free and needing no contrast media method for guiding transthoracic interventional occlusion for treatment of CHD, worthy of clinical popularization and application.

AIM To speculate the hypoglycemic mechanism for rats with type 2 diabetes by exploring the therapeutic effects of leaf aqueous extract from Cyclocarya paliurus on liver insulin receptor (InsR) and insulin receptor substrate 2 (IRS-2).METHODS The diabetic rat model was established through intraperitoneal injection of streptozotocin and fed with high-fat diet.The moleled rats were equally assigned into the control group and leaf aqueous extract from Cyclocarya paliurus group (extract group).After the test extract was orally administrated for four weeks,body weight,urine output,food intake,water intake and fasting blood-glucose (FBG) were measured,and the levels of serum insulin,InsR and IRS-2 mRNA in liver tissue were investigated in rats.RESULTS Compared with the control group,the extract group showed a reduction in urine output,food intake,water intake,FBG and insulin levels.Meanwhile,the rats' body weights in extract group were presented a trend to increase.The gene expressions of InsR and IRS-2 in liver tissue were up-regulated.Moreover,the insulin sensitivity was improved.CONCLUSION The leaf aqueous extract from Cyclocarya paliurus can reduce FBS,improve insulin sensitivity,which may be associated with the increase of InsR and IRS-2 gene expression in liver tissue.

Objective To study the the treatment effects of Niuhuang-Xingnao pill on Alzheimer's diseases mice and its influence on the levels of Bcl-2, caspase-3 and C-caspase-3. Methods 50 APP/V717 mice were divided into the positive control group, the model group,Niuhuang-Xingnao pill high, medium and low dosage groups. 10 C57BL/6 mice were selected as blank control. The high, medium and low dosage groups were given 142, 71 and 35.5 mg/kgNiuhuang-Xingnao pill, the positive control group was given 10 mg/kg donepezil, the blank group and model group were given same volume normal salin. 1 time/day, and continuous administration for 60 d. Morris water maze experiment was performed to test the learning and memory ability in mice. The levels of CAT, SOD and GSH-Px were detected by the method of ELISA, while Bcl-2, caspase-3 and C-caspase-3 in the groups were detected by western-blotting. The apoptosis of hippocampus of mice were observed by the method of TUNEL. Results Compared with the model group, the third square time (36.58 ± 4.57 s, 32.46 ± 4.25 s, 29.71 ± 4.26 s vs.25.48 ± 3.91 s) of high, middle and low dose groups were significantly longer, cross time of the table (5.82 ± 0.87, 4.59 ± 0.76, 3.96 ± 0.75 vs.3.27 ± 0.53) were significantly higher (P<0.05). In the high, middle and low dose groups, the levels of GSH-Px (161.14 ± 14.01 U/mg, 150.76 ± 13.16 U/mg, 143.17 ± 12.54 U/mg vs. 120.78 ± 10.92 U/mg), SOD (14.25 ± 1.82 U/mg, 11.17 ± 1.65 U/mg, 7.24 ± 1.02 U/mg vs. 3.12 ± 0.31 U/mg), CAT (17.95 ± 2.16 U/mg, 16.72 ± 1.83 U/mg, 15.54 ± 1.47 U/mg vs. 13.25 ± 2.60 U/mg) were significantly higher (P<0.05);caspase-3 (1.13 ± 0.13, 1.25 ± 0.15, 1.41 ± 0.17 vs. 1.49 ± 0.20), C-caspase-3 (1.17 ± 0.14, 1.27 ± 0.16, 1.42 ± 0.18 vs.1.52 ± 0.23) significantly lower(P<0.05), Bcl-2 (0.88 ± 0.08, 0.79 ± 0.06, 0.67 ± 0.04vs. 0.59 ± 0.04) significantly higher(P<0.05).ConclusionsNiuhuang-Xingnao pill treatment of Alzheimer's disease in mice can effectively promote the expression of Bcl-2, caspase-3 and C-caspase-3 in the hippocampus of mice, inhibit the apoptosis of the cells in hippocampus.