Objective:To summarize the ultrasonographic features and prognosis of fetal persistent vitelline artery.Methods:The prenatal ultrasound features, genetic testing results, and prognosis of a fetus with an isolated persistent vitelline artery that was diagnosed in our hospital in December 2021 were retrospectively analyzed. Relevant articles were retrieved from CNKI, VIP, Wanfang, Yiigle, PubMed, Embase, and UpToDate databases using the terms "persistent vitelline artery", "type Ⅱ single umbilical artery", and "prenatal ultrasound" in both Chinese and English. Prenatal ultrasound features and prognosis of the persistent vitelline artery in fetuses were summarized using descriptive statistical analysis.Results:(1) Case report: In this case, ultrasound at 23 gestational weeks showed that an abnormally large blood vessel deriving from the celiac artery near the superior mesenteric artery entered the placenta through the umbilical opening in parallel with the umbilical vein. Color Doppler showed a blood flow spectrum like that in the umbilical artery. The transverse section image showed that bilateral umbilical arteries were not observed in the bladder and the free segment of the umbilical cord was in the shape of the Chinese character "Lyu". No obvious other structural abnormalities and a negative result of genetic testing were observed in the fetus. Followed up to one year old, the patient showed normal growth and development. (2) Literature review: A total of five articles involving four cases were retrieved (three in English and two in Chinese). Among the five cases, including the present case, one was terminated due to left renal agenesis and abnormal heart arteries ratio revealed by prenatal ultrasound, and the remaining four cases without obvious structural abnormalities in the prenatal ultrasound were born and developed well. Histopathological examination of the umbilical cord was performed in three cases, of which two with persistent vitelline artery had a distinct internal elastic lamina, and one with remained vitelline duct.Conclusions:The prenatal ultrasound of fetal persistent vitelline artery is typically characterized by an abnormal vessel that is derived from the abdominal aorta or superior mesenteric artery and plays the function of the umbilical artery. The prognosis of the isolated persistent vitelline artery is good, but a better understanding of such embryonic abnormalities is needed as there are few relevant reports at home and abroad.

Serum and glucocorticoid-inducible kinases (SGKs) are serine threonine protein kinases involved in the regulation of multiple signal transduction pathways in vivo. SGKs include SGK1, SGK2 and SGK3. SGK1 plays a crucial role in the development of diseases such as digestive inflammation and tumors by regulating inflammatory and immune responses through phosphorylation. This article briefly introduces the structure and function of SGK1, and describes the research progress and clinical significance of SGK1 in digestive diseases.

Diabetic cardiomyopathy refers to dysfunction of cardiac muscle in patients with diabetes that cannot be directly ascribed to hypertension， coronary heart disease or other defined cardiac abnormalities. Imbalance in metabolic flexibility is the underlying cause of diabetic cardiomyopathy， which is manifested as distorted nutrient sensing， slow substrate switching， and impaired energy homeostasis. In the case of diabetes/insulin resistance， cardiac fatty acid oxidation increases while glucose oxidation decreases， resulting in the imbalance in cardiac metabolic flexibility. Thus， the heart fails to switch substrates depending on the changes （taking food/fasting， rest/exercise） and the energy production in cardiomyocytes reduced， causing cardiac dysfunction. Moreover， the excessive cardiac fatty acid fails to be degraded by the mitochondrial β oxidation， triggering cardiac lipid accumulation and reduction in glucose oxidation. Therefore， the glucose in the pentose phosphate （PPP） and the hexosamine biosynthetic pathway （HBP） increases and the production of advanced glycation end products rises， inducing glycolipotoxicity. The intermediates of abnormal substrate metabolism cause oxidative stress， inflammation， mitochondrial dysfunction and further result in impaired myocardial function. Qi and blood are the main functional substances for the normal functioning of the body. Qi and blood harmonize and work together to defend against external pathogen， while disharmony of blood and Qi will induce the production of various pathological products that lead to the occurrence of diseases. The function and regulation of Qi-Blood movement are similar to those of metabolism. Qi deficiency and blood stasis， Qi stagnation and blood stasis， and other "blood-Qi disharmony" types run through the whole process of diabetic cardiomyopathy， and "blood-Qi disharmony" will affect systemic substrate metabolism and lead to impaired energy metabolism. By systematically explaining the relationship between "blood-Qi disharmony" and "metabolic flexibility" in diabetic cardiomyopathy， we provide scientific research and clinical formulation ideas for targeting "metabolic flexibility" in the prevention of diabetic cardiomyopathy with Qi-replenishing and Blood-activating medicinals.

Objective:To investigate the association of nonalcoholic fatty liver disease (NAFLD) and obesity with risk of atherosclerotic cardiovascular disease (ASCVD).Methods:A total of 1 486 individuals, including 1 051 males and 635 women aged (56.0±9.0) years, who underwent health check-up at the Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from January 2020 to November 2021 were enrolled. The participants were divided into non-NAFLD group ( n=564), NAFLD without obesity group ( n=689), and NAFLD with obesity group ( n=233) according to the presence of NAFLD and body mass index. The general information, smoking history, alcohol consumption, medical history and results of physical examination, laboratory tests and liver ultrasound of participants were collected from the electronic medical record system. Body mass index≥28.0 kg/m 2 was defined as obesity, fatty liver was diagnosed by ultrasonography, and ASCVD risk was assessed according to the criteria of the Chinese guideline on the primary prevention of cardiovascular diseases( 2020). Multivariate logistic regression model was used to analyse the relationship of NAFLD and obesity with risk of ASCVD. Results:The proportions of individuals at high risk for ASCVD in the non-NAFLD group, the NAFLD without obesity group and the NAFLD with obesity group were 27.5%(155/564), 50.1%(345/689) and 61.8%(144/233), respectively, and the proportions of individuals at high ASCVD risk in the NAFLD without obesity group and the NAFLD with obesity group were higher than that in the non-NAFLD group (all P<0.05), and the proportion in the NAFLD with obesity group was higher than the NAFLD without obesity group ( P<0.05). Multivariate logistic regression analysis showed that NAFLD was significantly associated with a higher risk of ASCVD after correction for sex, alcohol consumption and alanine aminotransferase, and the association was stronger in the NAFLD with obesity, and the results were unchanged after further correction for uric acid, fasting glucose and systolic blood pressure (all P<0.001). Conclusion:NAFLD is strongly associated with the risk of ASCVD with or without obesity, and obesity may strengthen this association.

Objective:To study the ultrasonographic characteristics of embryos/fetuses with normal or abnormal central nervous system (CNS) from 7 to 13 +6 weeks of gestation using high resolution two-dimensional ultrasound combined with HD-live silhouette technology and provide a reference for early diagnosis of CNS abnormalities. Methods:Eighty normal embryos/fetuses during 7-13 +6 weeks and 41 fetuses with CNS malformations in early pregnancy during 11-13 +6 weeks were selected to observe the ultrasonographic features of embryos/fetuses with normal or abnormal CNS using transvaginal high resolution two-dimensional ultrasound and HD-live silhouette technology. Descriptive analysis was performed on the results. Results:From seven weeks of gestational age, high resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically show the prosencephalon, mesencephalon and rhombencephalon. The rhombencephalon changed the most in the brain development of embryos. At nine weeks of gestation, cleared structures of pons curvature, the fourth ventricle and cisterna magna were observed. The developing cerebellum and the original Blake pouch cyst were seen at 10 weeks of gestation. From 11 to 13 +6 weeks, the most remarkable change was the choroid plexus of the fourth ventricle changed from perpendicular to parallel to the long axis of the neural tube. Of the 41 fetuses with CNS malformation, 16 (39.0%) were exencephaly, 11 (26.8%) were holoprosencephaly, five (12.2%) were encephalocele, four (9.7%) were anencephaly, three (7.3%) were fourth ventricle dilatation, and two (4.9%) were open spina bifida. Conclusions:High resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically display the morphological changes in embryonic embryos/fetuses with development of normal CNS at 7-13 +6 weeks, which is helpful to better understand the origin of CNS embryonic abnormalities and provide diagnostic clues for the early detection of CNS abnormalities.

Objective:To investigate the mechanism of microRNA-4298 (miR-4298) targeting inhibition of peptidylarginine deiminase 4 (PADI4) expression in U251 cells apoptosis induced by histone deacetylase inhibitor trichostatin A (TSA).Methods:The experiment was divided into TSA group (0.2 μmol/L TSA) and contral group. CCK8 method was used to detect the effect of TSA on the proliferation of U251 cells. Flow cytometry was used to detect the apoptosis level of U251 cells after drug action. Reverse transcription PCR and Western blotting experiments were used to determine the changes of PADI4 gene and protein expression after miR-4298 interference. Luciferase assay was used to determine the effects of miR-4298 on targeted binding and luciferase activity in the 3′UTR region of PADI4. U251 cells were transfected with PADI4 to observe the rescue effect of miR-4298 on apoptosis. Each experiment was divided into 3 groups, NC group, miR-4298 mimic group, TSA+ miR-4298 mimic group and NC group, miR-4298 inhibitor group, TSA+ miR-4298 inhibitor group.Results:U251 cells were treated with 0.2 μmol/L TSA for 4 days, the Absorbancy ( A) values of the control group was 1.168±0.148, which was higher than those of the TSA group (0.737±0.007), with statistically significant difference ( t=4.948, P=0.008). Compared with the control group, after treatment with 0.2 μmol/L TSA for 48 h, U251 cells showed obvious apoptosis (27.62%±3.49% vs. 4.99%±0.13%, t=11.190, P<0.001). Compared with those before the drug treatment, the PADI4 gene expression (0.386±0.020 vs. 0.903±0.021) and protein expression (0.276±0.041 vs. 0.777±0.031) after TSA treatment for 48 h both were decreased, with statistically significant differences ( t=30.400, P<0.001; t=16.770, P<0.001). The expression of miR-4298 during the process of TSA-induced U251 cell apoptosis increased (2.573±0.289 vs. 1.003±0.136; t=8.487, P=0.001). There was a negative correlation between the miR-4298 expression and PADI4 expression ( r=-0.877, P=0.002). Luciferase experiment confirmed that miR-4298 has targeted binding and luciferase inhibitory effects on the 3′UTR region of wild-type PADI4. Compared with NC group (0.920±0.026), the relative expression levels of PADI4 gene of miR-4298 mimic group (0.413±0.049) and TSA+ miR-4298 mimic group (0.213±0.035) were decreased, with statistically significant differences (all P<0.001). The PADI4 protein expression level change was consistent with the gene change trend. Compared with NC group (3.78%±0.68%), the apoptosis levels of miR-4298 mimic group (7.96%±1.10%) and TSA+ miR-4298 mimic group (13.74%±1.26%) were increased, with statistically significant differences ( P=0.005; P<0.001). Compared with NC group (0.183±0.025), the PADI4 gene expression of miR-4298 inhibitor group (0.483±0.032) and TSA+ miR-4298 inhibitor group (0.386±0.025) were increased, with statistically significant differences ( P<0.001; P=0.015). The PADI4 protein expression level change was consistent with the gene change trend. Compared with NC group (4.96%±0.59%), the apoptosis levels of miR-4298 inhibitor group (23.83%±2.20%) and TSA+ miR-4298 inhibitor group (9.55%±1.49%) were increased, with statistically significant differences (all P<0.001). In the rescue experiment, the expression level of PADI4 in miR-4298 mimic group was significantly increased ( P<0.001), while the expression level of PADI4 in miR-4298 mimic+ PADI4 group was relatively reversed ( P=0.002). Conclusion:miR-4298 can participate in the process of U251 cell apoptosis by targeting the expression of PADI4 gene, and miR-4298 may be the target of targeted intervention therapy for glioma.

To construct TeI3c/4c-based and temperature-inducible gene inactivation system (Thermotargetron) and to apply it to gene inactivation of mesophilic bacteria. The subunit of flagellum (fliC) and C4 dicarboxylate orotate:H⁺ symporter (dctA) genes were chosen as targets in the genome of Escherichia coli HMS174 (DE3) strain. According to recognition roles of TeI3c/4c intron, the fliC489a, fliC828s, fliC1038s and dctA2a sites were chosen as target sites. Gene-targeting plasmids were constructed based on pHK-TT1A by using overlap PCR method and transformed into HMS174 cells. An aliquot mid-log phase cultures of the transformants were shocked at 48 °C and plated on LB plate (containing chloramphenicol). Afterwards, gene mutants were screened by using colony PCR and DNA sequencing. After the mutants were obtained, the phenotypes of ΔfliC and ΔdctA gene mutants were characterized by using agar puncture and carbon metabolism experiments. Colony PCR and sequencing results show that TeI3c/4c intron was inserted in the designed sites of fliC and dctA genes. The gene-targeting efficiency of Thermotargetron system was 100%. Phenotype verification experiments of the mutants demonstrated that the cell motility of all ΔfliC mutants was damaged and the malate assimilation ability of ΔdctA mutant was deprived comparing to wild-type HMS174 strain. In our study, a temperature-inducible and high-efficiency gene inactivation system was established for mesophilic bacteria. This system could achieve high efficiency and precise gene inactivation by modulation of the incubation duration of the transformants at 48 °C.

Objective To discuss the correlation between family history of malignant neoplasms (MN-FH) and the clinicopathological features of patients with non-small cell lung cancer (NSCLC). Methods The clinicopathological data of 326 patients with NSCLC in Yangzhou University Affiliated Hospital from June 2016 to June 2018 were analyzed retrospectively. The patients were divided into two groups based on with or without MN-FH, and the clinicopathological features of the two groups were analyzed by χ 2 test. Results Of the 326 patients with NSCLC, 41 (12.6％) were in the MN-FH group and 285 (87.4％) in the MN-FH group. There were no significant differences in sex, age, smoking, location of tumors and histological classification between patients with or without MN-FH (χ 2 values were 0.031, 0.769, 0.546, 0.117, and 0.945, all P > 0.05), but in patients with MN-FH, the proportion of tumor diameter < 5 cm [65.9％ (27/41) vs. 42.5％(121/285), χ 2 = 14.173, P < 0.05], undifferentiation and low differentiation [70.7％ (29/41) vs. 53.7％(153/285), χ 2 = 4.224, P < 0.05], TNM stage Ⅲ+Ⅳ [65.9％ (27/41) vs. 46.7％ (133/285), χ 2 = 5.280, P <0.05], lymph node metastasis [78.0％ (32/41) vs. 60.0％ (171/285), χ 2 = 4.970, P < 0.05], distant metastasis [75.6％ (31/41) vs. 53.3％ (152/285), χ 2 = 7.224, P < 0.05], high degree of malignancy [70.7％ (29/41) vs. 51.6％ (147/285), χ 2 = 5.293, P < 0.05] and combination of other tumors [29.3％ (12/41) vs. 7.7％ (22/285),χ 2 = 17.817, P < 0.05] were significantly higher than those in patients without MN-FH. Conclusions NSCLC patients with MN-FH have a higher degree of malignancy. For people with MN-FH, physical examination is very important.

Objective To study the expression of ultra-conserved gene sequence uc.454 in non-small cell lung cancer (NSCLC) tissues and its clinical significance.Methods Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression level of uc.454 mRNA in 130 cases of NSCLC and adjacent normal tissues from Affiliated Hospital of Yangzhou University between January 2014 and December 2017,and its association with clinicopathological factors and prognosis of NSCLC patients was analyzed.Results The expression level of uc.454 mRNA in NSCLC tissues was lower than that in adjacent normal tissues (2.98 ±0.96 vs.13.95± 2.23,t =98.441,P ＜ 0.05),and its expression level was associated with tumor infiltration depth (x2 =7.823,P =0.040),TNM stage (x2 =20.719,P ＜ 0.01) and lymph node metastasis (x2 =24.142,P ＜ 0.01).The survival time of patients with low expression of uc.454 mRNA was shorter than that of patients with normal or high expression (26.9 months vs.43.7 months),and the difference was statistically significant (P ＜ 0.05).Conclusion The low expression of ultra-conserved gene sequence uc.454 mRNA is related to the occurrence,development and prognosis of NSCLC.

Objective? To retrieve, assess and integrate the best evidence for diet management in cirrhosis and hepatic encephalopathy patients. Methods? The evidences involving guidelines, evidence summary, best practice information book, systematic review and expert consensus on diet management for cirrhosis and hepatic encephalopathy patients were retrieved in National Guideline Clearinghouse (NGC), National Institute for Health and Clinical Excellence (NICE), the Cochrane Library, Joanna Briggs Institute (JBI) Evidence-based Practice Database, ClinicalKey Database, EBSCO Database, Pubmed, China Biology Medicine (CBM) by computer. The quality evaluation of literatures and the evidence extraction were carried out. This study also determined the quality grade and recommendation level of extracted evidence. Results? A total of 13 literatures were included with 2 guidelines and 11 systematic reviews. There were 9 best evidences summarized from five aspects including nutrition assessment, diet frequency, choice of foot category, intake demand of energy and protein, and other nutritional intake in hepatic encephalopathy patients. Conclusions? Cirrhosis and hepatic encephalopathy patients usually are with malnutrition which plays a decisive role in prognosis. This study summarized the best evidence on diet management of cirrhosis and hepatic encephalopathy patients so as to provide an evidence-based basis for medical staff and cirrhosis and hepatic encephalopathy patients to carry out diet management.