Objectives To analyze the risk factors and their predictive value for postoperative hypoxemia in Type-A aortic dissection(TAAD).Methods A single-center retrospective study was conducted among 146 consecutive patients diagnosed as TAAD and undergone aortic arch surgery from January 2018 to June 2021 in Nanfang Hospital of Southern Medical University.According to the lowest postoperative PaO2/FiO2 ratio within 24 hours,the patients were classified into two groups:hypoxemia group(PaO2/FiO2≤200 mmHg)and non-hypoxemia group(PaO2/FiO2>200 mmHg).The difference of preoperative oxygen index,duration of mechanical ventilation and mortality in hospital were analyzed between the two groups.The independent risk factors for postoperative hypoxemia were evaluated by multivariate logistic regression and the predictive value was analyzed by receiver operator character(ROC)curves.Results For TAAD patients,the incidence of postoperative hypoxemia was 45.9%.Compared to non-hypoxemia group,hypoxemia group exhibited longer duration of mechanical ventilation(P<0.001)and longer intensive care unit(ICU)length of stay(P<0.05).Moreover,patients with hypoxemia presented higher mortality during hospital(P=0.011).Multivariate regression analysis identified BMI as independent risk factor(OR=1.701,P<0.001)and preoperation PaO2/FiO2 ratio as protective factors for postoperative hypoxemia in patients with TAAD(OR=0.987,P=0.004).Area under the ROC curve of BMI was 0.848,the optimal cut-off point of BMI was 25.8 kg/m2.Area under the ROC curve of pre-operation PaO2/FiO2 ratio was 0.808,the optimal cut-off point of preoperation PaO2/FiO2 ratio was 265 mmHg.Conclusions BMI higher than 25.8 kg/m2 is an independent risk factor and preoperation PaO2/FiO2 ratio higher than 265 mmHg is a protective factor for postoperative hypoxemia in patients with TAAD.Subjects with hypoxemia had longer duration of mechanical ventilation,ICU stay and higher mortality.

Embryo Research ; Humans

The ventral part of the anteromedial thalamic nucleus (AMv) is in a position to convey information to the cortico-hippocampal-amygdalar circuit involved in the processing of fear memory. Corticotropin-releasing-factor (CRF) neurons are closely associated with the regulation of stress and fear. However, few studies have focused on the role of thalamic CRF neurons in fear memory. In the present study, using a conditioned fear paradigm in CRF transgenic mice, we found that the c-Fos protein in the AMv CRF neurons was significantly increased after cued fear expression. Chemogenetic activation of AMv CRF neurons enhanced cued fear expression, whereas inhibition had the opposite effect on the cued fear response. Moreover, chemogenetic manipulation of AMv CRF neurons did not affect fear acquisition or contextual fear expression. In addition, anterograde tracing of projections revealed that AMv CRF neurons project to wide areas of the cerebral cortex and the limbic system. These results uncover a critical role of AMv CRF neurons in the regulation of conditioned fear memory.

Objectives: This study aimed to observe the change of arachidonic acid-induced platelet aggregation rate (AA-Ag) and short-term adverse reactions after taking 50 or 100 mg/d aspirin(enteric-coated sustained-release formulation) or 100 mg/d aspirin (enteric-coated aspirin tablet)in the elderly Chinese population (aged 60 years or older). Methods: A total of 1 194 participants aged 60 or older, who should be recommended to take aspirin therapy due to medical reasons, were recruited and randomly assigned into three groups to receive enteric-coated sustained-release aspirin tablet (50 mg, once daily, group A), or 100 mg, once daily (group B) or enteric-coated aspirin tablet 100 mg once daily (group C), respectively. AA-Ag was measured after (14±3)days of aspirin treatment. Adverse events and bleeding events were recorded during the (28±3)days of follow-up. Results: The AA-Ag in group A (n=347), B (n=338) and C (n=332) post 14-day aspirin therapy were 6.65 (4.03,10.84)%, 5.89(3.22,10.03) % and 6.00(3.68,10.09) %, respectively (P>0.05). During the 28 days follow-up, the adverse events rate of group A (n=388), B (n=387) and C (n=385) was 3.87%,3.36%, and 7.95%, and the mild bleeding events rate was 3.09%, 2.33%, and 6.23%, respectively. Adverse events rate and mild bleeding events rate were significantly higher in group C than in group A and B (P<0.05). Conclusions: Compared with 100 mg-dose aspirin, 50 mg-dose aspirin achieves similar anti-platelet aggregation effect in this elderly Chinese population. The short-term adverse events and mild bleeding risk of aspirin with enteric-coated sustained-release formulation were fewer than that of enteric-coated formulation.

Objective To investigate the effect and safety of Gukang capsule combined with sodium hyaluronate injection on the treatment of the patients with osteoarthritis. Methods 94 osteoarthritis patients selected from December 2015 to March 2017 were randomly divided into study group (n=47) and control group (n=47). The control group were given sodium hyaluronate injection, the study group were received local injection of sodium hyaluronate combined with Gukang capsule. The changes of knee joint function (HSS scale score) and adverse reaction rate were recorded and compared before and after treatment in the two groups. Results Before treatment, there was no significant difference in HSS scores between the two groups. After treatment, the HSS score in the study group was significantly better than that in the control group (P<0.05). There were no significant differences in the adverse reactions between the 2 groups during the treatment. Conclusion Local injection of sodium hyaluronate combined with Gukang capsule on the treatment of osteoarthritis, which can significantly improve the clinical efficacy, the security is higher. .

OBJECTIVETo explore the inhibitory effect of migration-inducing gene 7 (Mig-7) gene silencing induced by retroviral-mediated small hairpin RNA (shRNA) on vasculogenic mimicry (VM), invasion and metastasis of human hepatocellular carcinoma (HCC) cells in vitro.

METHODSTwo target sequences (Mig-7 shRNA-1 and Mig-7 shRNA-2) and one negative control sequence (Mig-7 shRNA-N) were synthesized. The recombinant retroviral vectors carrying Mig-7 shRNA were constructed, and HCC cell line MHCC-97H were transfected with Mig-7 shRNA-1, Mig-7 shRNA-2, Mig-7 shRNA-N, or the empty vector, or treated with 125 µg/mL recombinant human endostatin (ES). Mig-7 expression in the treated cells was detected using semi-quantitative PCR and Western blotting. The inhibitory effect of Mig-7 silencing on VM formation was investigated in a 3-dimensional cell culture system; the changes in cell adhesion, invasion and migration were assessed with intercellular adhesion assay, Transwell invasion assay and Transwell migration assay, respectively.

RESULTSThe expression of Mig-7 at both mRNA and protein levels decreased significantly, VM formation, invasion and metastasis were suppressed, while intercellular adhesion increased significantly in MHCC-97H cells in Mig-7 shRNA-1 and Mig-7 shRNA-2 groups (P<0.05); such changes were not observed in cells transfected with Mig-7 shRNA-N or the empty vector, nor in cells treated with ES.

CONCLUSIONSMig-7 silencing by retroviral-mediated shRNA significantly inhibits VM formation, invasion and metastasis and increases the intercellular adhesion of the HCC cells, while ES does not have such inhibitory effects.

Objective To understand epidemiological characteristics of self -reported acute gastroenteritis in Hangzhou -Jiaxing -Huzhou area in Zhejiang Province.Methods According to the population capacity,the household interview was conducted among families selected by multi stage sampling method from July 2010 to June 2011,and one person who was approaching birthday in every family was selected for investigation, including symptoms and treatment of acute gastroenteritis.Results Totally 9 548 people were investigated.The monthly prevalence of acute gastroenteritis among the surveyed population was 2.95% and the incidence was 0.39 per person year.It was estimated that there would be 5.875 6 million cases of acute gastroenteritis occurred during this year in the area.Logistic regression analysis showed that monthly prevalence in female was higher than in male.The monthly prevalence reached the high level in July and August.The monthly prevalence in preschool children was the highest.The monthly prevalence in rural population was higher than that in the urban population.Besides,the monthly prevalence in those of family number ≥3 was higher than that of family number less than 3.Totally,56.38% of the cases visited docter,and 54.67% of the cases took antibiotics;13.48%reported work absence and 2.13% reported school absence due to the illness.Conclusion The disease burden of acute gastroenteritis could be heavy in Hangzhou -Jiaxing -Huzhou area.Gender,education,season,residence and the size of family may have some effects on the occurrence of acute gastroenteritis.

Primary small cell carcinoma (SCC) of the breast, an exceedingly rare and aggressive tumor, is often characterized by rapid progression and poor prognosis. We report a case of primary SCC of the breast that was diagnosed through pathologic and immunohistochemical examinations. Computed tomography (CT) scans failed to reveal a non-mammary primary site. Due to the scant number of relevant case summaries, this type of tumor is proved to be a diagnostic and therapeutic challenge. Therefore, we also reviewed relevant literature to share expertise in diagnosis, clinicopathologic characteristics, treatment, and prognosis of this type of tumor. Future studies with more cases are required to define more appropriate treatment indications for this disease.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; diagnostic imaging ; drug therapy ; metabolism ; pathology ; CD56 Antigen ; metabolism ; Carboplatin ; administration & dosage ; Carcinoma, Intraductal, Noninfiltrating ; diagnostic imaging ; drug therapy ; metabolism ; pathology ; Carcinoma, Small Cell ; diagnostic imaging ; drug therapy ; metabolism ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Mammography ; Nuclear Proteins ; metabolism ; Phosphopyruvate Hydratase ; metabolism ; Synaptophysin ; metabolism ; Taxoids ; administration & dosage ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism ; Ultrasonography

OBJECTIVETo study the diagnosis and treatment of gastrointestinal injury caused by magnetic foreign body ingestions in children.

METHODSA literature search was performed to identify all the studies related to gastrointestinal tract injury caused by ingesting magnetic foreign body using databases including Google, Medline, ISI Web of Knowledge, Ovid, Wanfang data, VIP, CNKI, degree dissertation, meeting abstracts, and request for document delivery. Language was limited to English, Chinese, Japanese, and Korean. Parameters studies were age at diagnosis, gender, country, regional distribution, number of magnetic foreign bodies, source of magnetic foreign bodies, clinical features, diagnosis, and method for foreign body removal.

RESULTSA total of 98 cases of magnet ingestion were identified from 17 countries and regions. There were 94 patients under the age of 18, with most children younger than 5 years old(62.2%,61/98). The age at peak incidence was 3 years old (16.3%, 16/98). Magnetic foreign bodies ingested included toys(74.5%), medical apparatus(8.2%), accessories(4.1%), and others(6.2%). The number of bodies ranged from 2 to 100. Eleven (11.2%) patients were complicated with allotriophagia or autism. Delay diagnosis and treatment existed in all the patients to varying extents, of whom one died from severe infection. Exploratory laparotomy showed a wide range of bowel damage from the esophagus to the colon, including perforation and intestinal fistula. Intestinal damage was the most common injury (51.0%), followed by intestine-colon fistula (15.3%). All the patients required bowel resection with anastomosis or fistula repair except for 2 children who were managed by endoscopic removal of the foreign bodies.

CONCLUSIONIngesting more than one magnet will lead to severe gastrointestinal injury. Early diagnosis and surgical intervention are important. More precautious measures should be taken for children aged younger than 5 years old.