OBJECTIVES: To evaluate the short-term outcomes of transcatheter pulmonary valve replacement (TPVR) using the Venus-P valve in patients with moderate-to-severe pulmonary regurgitation and right ventricular systolic dysfunction (RVSD) following surgical repair of complex congenital heart disease. METHODS: A retrospective analysis was conducted on patients undergoing Venus-P valve implantation (TPVR group, n=28) or surgical pulmonary valve replacement (SPVR group, n=19) at Fuwai Hospital between February 2014 and February 2024. All patients had moderate-to-severe pulmonary regurgitation with right ventricular ejection fraction less than 45% preoperatively. Postoperative pulmonary valve function and ventricular parameters were assessed at discharge and during a 6-month follow-up. RESULTS: All procedures were successfully completed with no early mortality. At 6 months, the TPVR group demonstrated significantly lower pulmonary valve transvalvular pressure gradients compared to the SPVR group (P<0.05). Both groups exhibited significant improvements from baseline in New York Heart Association (NYHA) functional class, biventricular ejection fractions, and right ventricular end-diastolic volume index (all P<0.05). The reduction in right ventricular end-diastolic diameter differed between the two groups (P<0.01). However, multivariable analysis revealed no association between this difference and surgical approach (β=4.4, P>0.05). In the TPVR group, QRS duration was significantly shortened postoperatively (P<0.01), with improvements in left ventricular end-diastolic volume index and cardiac index (both P<0.01), but these improvements did not differ significantly from the SPVR group (all P>0.05). During the follow-up, one patient in each group developed infective endocarditis within 1-month post-procedure; both were successfully treated with antibiotics. No other major complications were observed. CONCLUSIONS For patients with moderate-to-severe pulmonary regurgitation and RVSD, TPVR using the Venus-P valve effectively improves short-term pulmonary valve function and ventricular performance with a favorable safety profile, demonstrating potential as a minimally invasive alternative to SPVR .
Humans ; Pulmonary Valve Insufficiency/surgery* ; Retrospective Studies ; Pulmonary Valve/surgery* ; Heart Valve Prosthesis Implantation/methods* ; Ventricular Dysfunction, Right/physiopathology* ; Treatment Outcome ; Female ; Male ; Child ; Adult ; Heart Valve Prosthesis ; Adolescent ; Cardiac Catheterization/methods* ; Child, Preschool

Empathy is crucial for communication and survival for individuals. Whether empathy in pain contagion shows sex differences and its underlying mechanisms remain unclear. Here, we report that pain contagion can occur in stranger female rats, but not in stranger males. Blocking oxytocin receptors in the anterior cingulate cortex (ACC) suppressed pain contagion in female strangers, while oxytocin administration induced pain contagion in male strangers. In vitro, corticosterone reduces neuronal activation by oxytocin. During male stranger interactions, higher corticosterone decreased oxytocin receptor-positive neuronal activity in the ACC, suppressing pain contagion. These findings highlight the role of oxytocin in pain contagion and suggest that sex differences in empathy may be determined by the balance of oxytocin and corticosterone in the ACC. This study suggests an approach for the treatment of certain mental disorders associated with abnormal empathy, such as autism and depression.
Animals ; Oxytocin/pharmacology* ; Gyrus Cinguli/drug effects* ; Male ; Female ; Corticosterone/pharmacology* ; Empathy/drug effects* ; Sex Characteristics ; Receptors, Oxytocin/antagonists & inhibitors* ; Pain/psychology* ; Rats ; Rats, Sprague-Dawley ; Neurons/metabolism*

Amorphous calcium phosphate（ACP）is a component of urinary stones，primarily forming mixed stones with calcium oxalate，while pure ACP stones are relatively rare. This article reports a case of a patient with an ACP bladder stone who was admitted due to progressive dysuria over 5 years，which had worsened in the past months. Upon admission，tPSA was 29.63 ng/ml. CT and enhanced MRI revealed multiple bladder stones and prostatic hyperplasia. The patient underwent ultrasound-guided prostate biopsy and transurethral cystolithotripsy with pneumatic lithotripsy. Postoperative infrared spectroscopy confirmed the stone composition as ACP，and prostatic adenocarcinoma was diagnosed by prostate biopsy pathology. Endocrine therapy was administered postoperatively，and follow-up imaging at 3 months showed no stone. This article presents the first reported case of an ACP bladder stone coexisting with prostate cancer，providing important clinical insights into the etiology of such stones and the rare local manifestations of prostate cancer.

The lung collaterals form a network that branches from the lung meridian, traversing the lung system and extending across the body′s surface. Lung collateral disease refers to the structural alterations or dysfunction in these collaterals caused by external or internal pathogens. Research into the structural and physiological functions of children′s lung collaterals, as well as the pathogenesis and syndrome differentiation for treating lung collateral diseases in children, holds significant value in guiding the prevention and treatment of pediatric respiratory conditions. Drawing on the theory of collateral disease, the clinical insights of both historical and contemporary physicians, and modern research findings—while considering the unique physiological and pathological characteristics of children′s respiratory systems—this study provides a foundational summary of the morphology and spatial distribution of children′s lung collaterals. The characteristics of these collaterals are highlighted as thin, sparse, short, narrow, brittle, and tender. From this structural understanding, the unique physiological functions of children′s lung collaterals are analyzed. The study further explores the interactions between pathogenic factors and lung collaterals, elucidating the pathogenesis and progression of children′s lung collateral diseases. It proposes treatment principles centered on "seeking treatment in the collaterals and employing the method of unblocking collaterals, "which align with the unique features of pediatric lung collaterals. Common treatment approaches, and relevant prescriptions for managing these diseases are summarized. This paper lays the foundation for a theoretical system encompassing the structure, function, pathogenesis, and syndrome differentiation for treating children′s lung collateral diseases. It offers valuable insights for the clinical diagnosis and management of pediatric respiratory diseases linked to collateral dysfunction and serves as a reference for the systematic development of a broader theoretical framework for children′s collateral diseases.

Here reports a rare case of severe pneumonia with pulmonary abscess and empyema caused by Trophe-ryma whipplei(TW)infection.TW infection was confirmed by clinical manifestations as well as polymerase chain reaction(PCR)of bronchoalveolar lavage fluid(BALF)and pleural effusion.After treatment with meropenem(fo-llowed by sequential ceftriaxone)combined with compound sulfamethoxazole,the patient improved and was dis-charged from hospital.Combined with literature review,this study explores the clinical manifestations,laboratory examinations,and treatment scheme of TW infection,aiming to improve the awareness and vigilance of clinicians on TW infection,conduct targeted anti-infection therapy as early as possible,and reduce the mortality of patients.

Here reports a rare case of severe pneumonia with pulmonary abscess and empyema caused by Trophe-ryma whipplei(TW)infection.TW infection was confirmed by clinical manifestations as well as polymerase chain reaction(PCR)of bronchoalveolar lavage fluid(BALF)and pleural effusion.After treatment with meropenem(fo-llowed by sequential ceftriaxone)combined with compound sulfamethoxazole,the patient improved and was dis-charged from hospital.Combined with literature review,this study explores the clinical manifestations,laboratory examinations,and treatment scheme of TW infection,aiming to improve the awareness and vigilance of clinicians on TW infection,conduct targeted anti-infection therapy as early as possible,and reduce the mortality of patients.

Amorphous calcium phosphate（ACP）is a component of urinary stones，primarily forming mixed stones with calcium oxalate，while pure ACP stones are relatively rare. This article reports a case of a patient with an ACP bladder stone who was admitted due to progressive dysuria over 5 years，which had worsened in the past months. Upon admission，tPSA was 29.63 ng/ml. CT and enhanced MRI revealed multiple bladder stones and prostatic hyperplasia. The patient underwent ultrasound-guided prostate biopsy and transurethral cystolithotripsy with pneumatic lithotripsy. Postoperative infrared spectroscopy confirmed the stone composition as ACP，and prostatic adenocarcinoma was diagnosed by prostate biopsy pathology. Endocrine therapy was administered postoperatively，and follow-up imaging at 3 months showed no stone. This article presents the first reported case of an ACP bladder stone coexisting with prostate cancer，providing important clinical insights into the etiology of such stones and the rare local manifestations of prostate cancer.

Platelet elevation is a rare manifestation in the peripheral blood of patients with chronic myeloid leukemia (CML). In this paper, we report for the first time a case of CML combined with cerebral hemorrhage manifested by abnormally elevated platelets. The patient had elevated platelets in the peripheral blood, showed normal coagulation function, and underwent intracranial hematoma removal due to cerebral hemorrhage. After the operation, bleeding from the operated area and other systems occurred, and the patient was diagnosed as having accelerated CML after combining bone marrow biopsy and genetic testing. His condition was controlled after administration of flumatinib through a jejunal tube. Based on this patient's experience, the feasibility ofadministering flumatinib via a jejunostomy tube was determined, which is the first report of its kind in China and abroad.This article summarizes the diagnosis and treatment process of this patient, with the aim of providing a warning and reference for clinicians.

Objective To summarize the multi slice spiral computed tomography(MSCT)features of bronchiolar adenoma(BA).Methods The imaging data of 9 cases of BA confirmed by surgery and pathology were analyzed retrospectively,and relevant literature was also reviewed.Results Among the 9 cases of BA,there were 8 cases with peripheral BA(away from the pleura≤5 mm)inclu-ding 4 cases close to the pleura and 1 case in central area.BA were located in the superior lobe of the right lung in 3 cases,the middle lobe of the right lung in 2,the inferior lobe of the right lung in 2,and the inferior lobe of the left lung in 2.Five cases were solid nod-ules,2 were ground-glass nodules and other 2 were cystic cavity nodules.In 2 cases of the solid nodules,the boundary on the non-venous side was blurred.In the 1 case of the ground-glass nodule,linear and reticular shadows were observed in the lesion,accompanied by a blurred boundary.2 nodules had mild pleura indentation,and other 7 nodules were found blood vessels entering into or adhering to the lesion,3 of which were accompanied by vascular thickening.In 8 cases with 2-48 month followed up,1 cystic cavity nodule was accompa-nied by obstructive pneumonia and then inflammatory absorption,1 solid nodule enlarged accompanied by the appearance of vacuoles,and the rest 6 had no changes.One central type nodule was operated after the CT examination.Conclusion BA are mainly manifes-ted as peripheral nodules of the lung,mostly close to the pleura and away from the pleura≤5 mm.Most BA are solid nodules,and sometimes are ground-glass or cystic cavity nodules.Some nodules show blurred boundaries or inflammation on the non-venous side,and few nodules increase during follow-up,with or without small vacuoles.

By analyzing the of genetic testing data of patients with renal polycystic kidney disease and their relatives, this study aims to identify unreported novel gene mutation sites associated with autosomal dominant polycystic kidney disease (ADPKD). Structural prediction software was employed to investigate protein structural changes before and after mutations, explore genotype-phenotype correlations, and enrich the ADPKD gene database. In this single-center retrospective study, patients with multiple renal cysts diagnosed from January 2019 to February 2023 at the Zhong Da Hospital Southeast University were included. Genetic and clinical data of patients and their families were collected. Unreported novel gene mutation sites associated with ADPKD were identified. The AlphaFold v2.3.1 software was used to predict protein structures. Changes in protein structure before and after mutations were compared to explore genotype-phenotype correlations and enrich the ADPKD gene database. Twelve mutated genes associated with renal cysts were detected in 52 families. Nineteen novel gene mutation sites associated with ADPKD were identified, including 17 mutations in the PKD1 gene (one splicing mutation, seven frameshift mutations, four nonsense mutations, one whole-codon insertion, and four missense mutations); one ALG9 missense mutation; and one chromosomal structural variation. Truncating mutations in the PKD1 gene were correlated with a more severe clinical phenotype, while non-truncating mutations were associated with greater clinical heterogeneity. Numerous novel gene mutation sites associated with ADPKD remain unreported. Therefore, it is essential to analyze the pathogenicity of these novel mutation sites, establish genotype-phenotype correlations, and enrich the ADPKD gene database.