Background: Patients with coarctation of the aorta (CoA) and an interrupted aortic arch (IAA) may present with small mitral valves (MVs) and a reduced left ventricular (LV) volume. Biventricular repair (BVR) in these patients is dependent on adequate size of the left cardiac structures.Purpose: This study evaluated the impact of the hemodynamic characteristics of atrial septal defects (ASDs) on MV growth following surgical repair. Methods: We retrospectively reviewed the data of patients diagnosed with CoA or IAA between 2007 and 2024. The z score for MV size measured 6 months postoperatively (Z2) was compared with the preoperative MV size (Z1). The factors associated with MV growth were also studied. Results: A total of 161 patients with CoA or IAA were included. Transthoracic echocardiography was used to assess the MV and LV dimensions preoperatively and 6 months postoperatively. Of the cohort, 155 (96.3%) underwent initial BVR and 6 underwent single-ventricle palliation. MV z scores significantly increased following BVR (mean change: +0.45±1.35; P<0.001) but decreased after single-ventricle repair (-0.56±0.49, P=0.04). Multivariate analysis identified the initial MV z score and ASD pressure gradient as independent predictors of MV growth (R2=0.39). Conclusion Annular growth of the MV was not observed in patients who underwent single-ventricle palliation. In contrast, among patients who achieved BVR, those with a small preoperative MV annulus and low ASD pressure gradient demonstrated subsequent catch-up MV growth, suggesting that adequate left-sided preload is essential for MV development.

Depression is a common psychiatric disorder characterized by persistent low mood or mental disorders. Current treatments primarily focus on regulating neurotransmitter levels， but their effectiveness is limited. The mechanisms underlying its onset are complex， and there is no unified consensus. Abnormal signaling pathway transmission plays a crucial role in the development of depression， involving multiple pathways， including Toll-like receptor 4/nucleotide-binding oligomerization domain-like receptor protein 3 （TLR4/NLRP3）， nuclear factor-κB （NF-κB）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， mitogen-activated protein kinase/extracellular signal-regulated kinase （MAPK/ERK）， brain-derived neurotrophic factor/tyrosine kinase receptor B （BDNF/TrkB）， cyclic AMP/protein kinase A/cAMP response element-binding protein （cAMP/PKA/CREB）， and others. Traditional Chinese medicine（TCM） is based on a holistic approach and the principle of treatment based on the differentiation of syndromes， regulating the balance of multiple systems and organ functions from a macroscopic perspective. This approach has shown unique advantages in the treatment of depression. TCM attributes the onset of depression to dysfunction of the organ systems， involving liver Qi stagnation， heart spirit deficiency， kidney essence depletion， and spleen dysfunction. TCM compound treatments focus on soothing the liver， strengthening the spleen， calming the heart， and replenishing essence， with formulas such as Xiaoyaosan， Zishui Qinggan Yin， and Chahu Jia Guizhi Longgu Muli Tang. The active components of Chinese herbs mainly aim to tonify and regulate Qi， such as salidroside， ginsenoside Rb₁， astragaloside， and muscone. External TCM treatments， primarily acupuncture， aim to open the orifices and invigorate the spirit. Acupoints such as Baihui， Shenting， and Yintang are commonly used. Additionally， massage and moxibustion therapy can intervene in depression by regulating signaling pathways. This article reviews the core role of signaling pathways in the development of depression and the mechanism of TCM regulation of signaling pathways to intervene in depression， aiming to discover new therapeutic approaches that can improve the symptoms of depressed patients.

Objective To explore the efficacy and safety of combined Xuezhikang Capsule with low-dose statin for patients with atherosclerotic plaques in carotid arteries.Methods A total of 240 inpatients and outpatients with carotid atherosclerosis admitted in Qingtian County Hospital of Traditional Chinese Medicine from May 2022 to March 2023 were recruited,and randomly divided into a control group and an observation group,with 120 patients in each group.The control group was given oral administration of atorvastatin,while the observation group was given same dose of atorvastatin in combination with Xuezhikang Capsule.The clinical efficacy,blood lipids before and after treatment,and safety were compared between the two groups.Results The LDL-C levels at 8 and 24 weeks after treatment were significantly lower in the observation group than the control group(P＜0.05,P＜0.01).The change in LDL-C level in the observation group was obviously higher than that of the control group after treatment(P＜0.05).The alanine transaminase level was notably lower in the observation group than the control group after 24 weeks of treatment(26.74±7.66 U/L vs 31.53±10.18 U/L,P＜0.01).There was no statistical difference in the inci-dence of adverse reactions between the two groups(P＞0.05).Conclusion In the treatment of pa-tients with carotid atherosclerosis,Xuezhikang Capsule combined with low dose of statin can re-duce blood lipid with high safety.

Objective To initially explore the possibility of applying the fluorescence micro-optical sectioning tomography(fMOST)high-resolution 3D reconstruction system to the morphological study of the intestinal nervous system and to preliminarily establish a method for studying the morphology of the intestinal nervous system using this system.Methods fMOST high-resolution 3D reconstruction system was used to study the intestinal nervous system of C57BL/6 mice in detail.Based on this method,a new morphological method of the visceral nervous system of small animal models was explored at the single-cell level.Results Compared with the large intestine,the small intestine lacked the typical myenteric plexus(Auerbach),deep mucosal plexus(Henley),and submucosal superficial plexus(Meissner).Conclusion The result of this paper provide a clearer and systematic display of the anatomical structure of the enteric nervous system in C57BL/6 mice,and further clarify the similarities and differences between the enteric nervous system of mice and human,and provide a theoretical basis for its rational application in the study of digestive system diseases.The morphological study of fMOST high-resolution 3D reconstruction system is not limited to the central nervous system,but can be extended to the morphological study of multiple visceral nervous systems.

Objective To observe the morphology of the superficial,middle,and deep layers of the masseter muscle and related bony structures in the lateral facial region of adults through gross anatomy,and to probe into the effects of these muscle layers on the bony structures of the lateral facial region.Methods The bilateral masseter muscles of 12 adult cadavers were exposed,and the superficial,middle,and deep layers were separated and measured for muscle length,tendon length,and muscle belly length.After the masseter muscles were stripped,the total thickness was measured,and the mandible and zygomatic arch were exposed to measure the angle of the mandibular angle,thickness of the zygomatic arch,and width of the zygomatic arch.Observations were made of the masseter tuberosities,and statistical analysis was conducted on their interrelations.Results The zygomatic arch thickness was positively correlated with the length of superficial,middle and deep masseter muscles and the length of superficial and middle masseter belly(r superficial masseter length=0.624,r middle masseter length=0.787,r deep masseter length=0.423,r superficial masseter belly length=0.493,r middle masseter belly length=0.548).The width of the zygomatic arch was positively correlated with the lengths of the superficial and middle muscle layers and the middle muscle belly length(r superficial masseter length=0.527,r middle masseter length=0.521,r middle masseterbelly length=0.437).The angle of the mandibular angle was only negatively correlated with the middle muscle belly length(r=-0.422).The tuberosities of the superficial and middle masseter muscles were not affected by the corresponding muscle layers;However,the tuberosity of the deep masseter was negatively correlated with the length of the deep muscle and the length of the deep tendon(r deep masseter length=-0.543,r deep masseter tendon length=-0.443).Conclusion In the masseter muscle layers of Chinese individuals,the superficial and middle layers have the most significant impact on the bony structures structures of the lateral facial region.These findings are of guiding significance for the remodeling of structures in the lateral facial region.

Objective To explore the advantages and disadvantages of da Vinci robotic-assisted thoracoscopic resection of pediatric posterior mediastinal tumors compared to traditional thoracoscopic surgery.Methods A total of 79 pediatric patients who underwent posterior mediastinal tumor resection at Union Hospital,Tongji Medical College,Huazhong University of Sci-ence and Technology,between January 2018 and October 2021 were included.Among them,47 patients underwent da Vinci ro-botic-assisted thoracoscopic surgery(Group A),and 32 patients underwent traditional thoracoscopic surgery(Group B).The pa-tients'age,gender,weight,tumor type,size,surgical time,intraoperative and postoperative complications,and other factors were compared and analyzed.Results There were 44 male and 35 female patients,with an average age of 4.5 years[(4.7±2.4)vs.(4.4±1.8),P=0.19]and an average weight of 21.7 kg[(23.6±7.5)vs.(20.9±6.1),P=0.10].Tumor sizes were(5.2±3.1)cm vs.(4.5±2.3)cm(P=0.07).All surgeries were completed safely with no intraoperative deaths.Pathological re-sults showed 25 cases of ganglioneuroma,19 cases of ganglioneuroblastoma,16 cases of neuroblastoma,10 cases of lymphangio-ma,8 cases of foregut cyst,and 1 case of lipoblastoma.One patient required conversion to thoracotomy due to intraoperative bleeding.The average anesthesia time[(127±25)vs.(124±30)min,P=0.42]and the operative time[(84±17)vs.(102±27)min,P=0.02)were significantly different.Estimated intraoperative blood loss[(14.6±4.4)vs.(15.4±5.3)mL,P=0.38]and the chest drainage time[(3.7±2.5)vs.(4.1±3.0)days,P=0.09]varied between groups.The average lengths of hospital stay were different[(7.2±1.9)vs.(7.4±2.3)days,P=0.40].Postoperative complications included 1 case of chylo-thorax,3 cases of pneumothorax,and 1 case of Horner's syndrome in Group A.There were 1 case of hemothorax,4 cases of pneumothorax,and 1 case of Horner's syndrome in Group B.Patients with ganglioneuroblastoma and neuroblastoma received postoperative chemotherapy.Follow-up for 2 to 5 years showed that all children recovered well,with no recurrence.Conclusion Both da Vinci robotic-assisted surgery and traditional thoracoscopic surgery are safe and feasible for pediatric mediastinal tumor surgery.The optimized instruments of the da Vinci robotic surgical system offer advantages in surgeries involving larger tumors or complex anatomical structures.

Objective:To explore the differentially expressed tRNA-derived RNA fragment(tRF)and tRNA halves(tiRNA)in plasma of collagen-induced arthritis(CIA)rats,analyze the biological functions and related pathways of the tRF and tiRNAs target genes in order to identify new targets for diagnosis and therapy of rheumatoid arthritis(RA).Methods:Rat model of RA was estab-lished by injecting typeⅡ collagen.Arthritis index(AI)score and HE staining were conducted to evaluate the successfully establishment model.Illumina platform was used to obtain the tRF and tiRNA expression profiles.RT-qPCR was performed to validate expressions of tRF and tiRNA.Combining miRanda and TargetScan databases,the target genes of differentially expressed tRF and tiRNA were ob-tained.GO and KEGG enrichment analysis were used to annotate the functions of target genes.Results:A total of 25 tRFs and tiRNAs were significantly differentially expressed in plasma in rats after modeling,of which 23 were up-regulated and 2 were down-regulated.Besides,six specifically expressed tRFs and tiRNAs induced by CIA rats were screened,including Other-36:73-tRNA-Arg-CCT-4,Other-57:70-tRNA-Glu-CTC-1-M3,tRF-1:32-Gly-CCC-1-M2,tRF-1:31-Gly-CCC-1-M2,tRF-1:32-Pro-AGG-1-M4 and tRF-1:32-Glu-TTC-2-M2.GO analysis of target genes mainly involved organelle-associated items.What's more,KEGG analysis enriched multi-ple classical signal pathways associated with RA.Conclusion:Target genes of differentially expressed tRFs and tiRNAs in CIA rats may be involved in regulating important pathophysiological processes of RA and drug therapy targets.

Ischemic stroke is the leading cause of death and disability among adults worldwide. T lymphocytes can be divided into αβT cells and γδT cells. Among them, αβT cells can be further divided into subgroups such as CD4? T cells, CD8? T cells, and natural killer (NK) cells. In CD4? T cells, T helper cells (Th) 1 and Th17 secrete pro-inflammatory cytokines, which can exacerbate ischemic brain injury; Th2 secretes anti-inflammatory factors, which can improve neurological function. Regulatory T cells (Tregs) exert neuroprotective effects through various mechanisms. CD8? T cells exacerbate ischemic brain injury by secreting cytokines and releasing granzyme, while NK cells can cause neuronal damage and blood-brain barrier damage by secreting interferon-γ. In addition, interleukin-17 secreted by γδT cells also plays a significant pro-inflammatory role in the pathological process of stroke. Therefore, a deeper understanding of the role of T lymphocytes can provide new ideas for the treatment of ischemic stroke.

Purpose: Colorectal cancer (CRC) often spreads to the liver, necessitating surgical treatment for CRC liver metastasis (CRLM). Iron-deficiency anemia is common in CRC patients and is associated with fatigue and weakness. This study investigated the effects of iron-deficiency anemia on the outcomes of surgical resection of CRLM. Methods: This population-based, retrospective study evaluated data from adults ≥20 years old with CRLM who underwent hepatic resection. All patient data were extracted from the 2005–2018 US National (Nationwide) Inpatient Sample (NIS) database. The outcome measures were in-hospital outcomes including 30-day mortality, unfavorable discharge, and prolonged length of hospital stay (LOS), and short-term complications such as bleeding and infection. Associations between iron-deficiency anemia and outcomes were determined using logistic regression analysis. Results: Data from 7,749 patients (representing 37,923 persons in the United States after weighting) were analyzed. Multivariable analysis revealed that iron-deficiency anemia was significantly associated with an increased risk of prolonged LOS (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 2.30–3.30), unfavorable discharge (aOR, 2.42; 95% CI, 1.83–3.19), bleeding (aOR, 5.05; 95% CI, 2.92–8.74), sepsis (aOR, 1.60; 95% CI, 1.04–2.46), pneumonia (aOR, 2.54; 95% CI, 1.72–3.74), and acute kidney injury (aOR, 1.71; 95% CI, 1.24–2.35). Subgroup analyses revealed consistent associations between iron-deficiency anemia and prolonged LOS across age, sex, and obesity status categories. Conclusion In patients undergoing hepatic resection for CRLM, iron-deficiency anemia is an independent risk factor for prolonged LOS, unfavorable discharge, and several critical postoperative complications. These findings underscore the need for proactive anemia management to optimize surgical outcomes.

Oligodendrocyte lineage cells, including oligodendrocyte precursor cells (OPCs) and oligodendrocytes (OLs), are essential in establishing and maintaining brain circuits. Autophagy is a conserved process that keeps the quality of organelles and proteostasis. The role of autophagy in oligodendrocyte lineage cells remains unclear. The present study shows that autophagy is required to maintain the number of OPCs/OLs and myelin integrity during brain aging. Inactivation of autophagy in oligodendrocyte lineage cells increases the number of OPCs/OLs in the developing brain while exaggerating the loss of OPCs/OLs with brain aging. Inactivation of autophagy in oligodendrocyte lineage cells impairs the turnover of myelin basic protein (MBP). It causes MBP to accumulate in the cytoplasm as multimeric aggregates and fails to be incorporated into integral myelin, which is associated with attenuated endocytic recycling. Inactivation of autophagy in oligodendrocyte lineage cells impairs myelin integrity and causes demyelination. Thus, this study shows autophagy is required to maintain myelin quality during aging by controlling the turnover of myelin components.
Animals ; Autophagy/physiology* ; Oligodendroglia/metabolism* ; Myelin Sheath/physiology* ; Aging/pathology* ; Myelin Basic Protein/metabolism* ; Cell Lineage/physiology* ; Mice ; Oligodendrocyte Precursor Cells ; Mice, Inbred C57BL ; Brain/cytology* ; Cells, Cultured ; Cell Count