Objective To investigate the correlation between serum leptin level and body mass index(BMI)in in-fants with cyanosis congenital heart disease,and the relationship between leptin and Ob gene receptor(Ob-R)and hypoxia-inducible factor 1α(HIF-1α)in myocardium.Methods A total of 52 children under 6 months of age with congenital heart disease who underwent surgical treatment in the Department of Congenital Heart Surgery,Fuwai Hospital from January 2019 to October 2020 were included in this study.According to the arterial partial pressure of oxygen(PaO2)of 90 mmHg,they were divided into cyanotic group(n=30)and acyanotic group(n=22).Their height and weight were collected to calculate BMI.The serum leptin level was measured by ELISA.The ex-pressions of HIF-1α and Ob-R in myocardial tissue were detected by RT-PCR and Western blot.In animal mod-el,SD rats were divided into normoxia group and hypoxia intervention group,which were subjected to continuous hypoxia(10％ O2)for 4 weeks.The hypoxia intervention group received intraperitoneal injection of HIF-1α in-hibitor digoxin(2 mg/kg)daily from the 14 th to 21st day of hypoxia,respectively.The body weight of rats was recorded,and the expressions of HIF-1α and Ob-R were detected by RT-qPCR and Western blot.Results Com-pared with the acyanosis group,the cyanosis group had a significantly lower BMI(P<0.05)and a lower leptin/BMI ratio(leptin/BMI)(P<0.05).Spearman correlation analysis confirmed that serum leptin in the circulatory system was positively correlated with BMI(P<0.05).In the cyanosis group,the expression of Ob-R increased with the upregulation of HIF-1α,showing a positive correlation.In animal model,with the down-regulation of HIF-1α expression in digoxin injection,the Ob-R level was significantly lower than that in the control group(P<0.05),the trend of weight loss was significantly inhibited(P<0.05).The right ventricular hypertrophy in-dex was significantly lower than that in the control group(P<0.05).Conclusions HIF-1α regulates the expres-sion of Ob-R in myocardial tissue,and the mechanism of its association with leptin and Ob-R may help to find new therapeutic target for improving the prognosis of infants with congenital heart disease.

Objective:To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods:From March 2021 to March 2022, 240 children underwent cone beam computed tomography（CBCT） in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results:For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors（P>0.05）. The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union（MIOU） s （86.32±0.54）%; Dice Similarity Coefficient（DSC）: （92.91±0.23）%; Accuracy: （95.92±0.25）%; Precision: （91.93±0.14）%; and the model evaluation index of Adenoid volume: MIOU: （86.28±0.61）%; DSC: （92.88±0.17）%; Accuracy: （95.90±0.29）%; Precision: （92.30±0.23）%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/（AV+NAV） in 240 children of different age groups（P<0.05）, and the correlation coefficient of 9-13 years old was 0.74. Conclusion:The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability.
Child ; Humans ; Adolescent ; Adenoids/diagnostic imaging* ; Image Processing, Computer-Assisted/methods* ; Pharynx ; Cone-Beam Computed Tomography ; Nose

Objective:To explore the medical reference values, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health conditions, and to evaluate the importance of serum iodine in evaluating individual iodine nutrition.Methods:From February 2017 to November 2018, multi-stage stratified cluster sampling was used to select one community and one agricultural (fishing) village in the coastal Yingkou City and the inland areas of Shenyang City of Liaoning Province as survey sites. Cluster sampling of adults over 18 years old who had lived for five years were conducted with questionnaire survey, clinical physical examination and thyroid ultrasound examination. Fasting venous blood samples and one random urine sample were collected from all subjects for serum iodine, thyroid hormone, antibody and urine iodine detection. The 95% medical reference value of serum iodine was established by using the percentage quantile method, and the reference value, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health status were analyzed. The diagnostic value of iodine nutritional indicators in thyroid diseases was evaluated by the receiver operating characteristic (ROC) curve.Results:A total of 2 931 adults were surveyed, with serum iodine levels of 62.1 (53.6, 72.2) μg/L, ranging from 5.6 to 642.3 μg/L; urine iodine was 167.6 (111.2, 244.2) μg/L, and the overall iodine level was at an appropriate level. A total of 1 089 patients with thyroid diseases were examined, with a detection rate of 37.2% (1 089/2 931); among them, there were 597 cases of thyroid nodules, 56 cases of endemic goiter, 42 cases of hypothyroidism, 161 cases of subclinical hypothyroidism, 27 cases of hyperthyroidism, 18 cases of subclinical hyperthyroidism, and 474 cases of autoimmune thyroid disease (AITD). There was a statistically significant difference in the detection of thyroid diseases among adults with different levels of serum iodine (χ 2 = 13.80, P < 0.05). The reference values of serum iodine in normal adults, hypothyroidism (without thyroid hormone intervention), hyperthyroidism (without anti thyroid hormone drug treatment), AITD, endemic goiter, and thyroid nodules were 37.2 - 103.0, 12.5 - 52.8, 49.9 - 163.1, 34.3 - 129.3, 27.3 - 92.8, and 37.9 - 119.5 μg/L, respectively. The ROC curve analysis results showed that the serum iodine area under curve(AUC) of patients with hyperthyroidism, subclinical hyperthyroidism, endemic goiter, thyroid nodules, and AITD were 0.94, 0.61, 0.55, 0.53, and 0.52, respectively. The results of univariate analysis showed that there were statistically significant differences in adult serum iodine levels among different positions, regions, age, education level, occupation, iodine intake, blood pressure, and body mass index ( P < 0.05). Conclusions:There are significant differences in serum iodine levels among adults with different thyroid health conditions, and evaluation standards and systems should be developed separately. Serum iodine is an important indicator for evaluating individual iodine nutrition.

Objective:To explore the clinical characteristics of pneumocystis carinii pneumonia (PCP) after kidney transplantation.Methods:From January 2020 to January 2022, clinical data were retrospectively reviewed for 13 renal transplant recipients with pneumocystis pneumonia diagnosed by metagenomics next generation sequencing (mNGS). There were 3 females and 10 males with an age range of (46±10) years.The median time of postoperative onset was 10(2-21) months; The major clinical manifestations included fever ( n=11), cough ( n=7), expectoration ( n=6) and dyspnea ( n=11). Paired t-test was employed for analyzing the laboratory results at admission and discharge. Results:The diagnosis was confirmed by the detection of NGS in alveolar lavage fluid or venous blood.The levels of G test, LDH test, total T lymphocyte absolute count (CD3+ Abs), inhibitory/cytotoxic T lymphocyte count (CD3+ CD8+ Abs) and auxiliary/induced T lymphocyte absolute count (CD3+ CD4+ Abs) were (543.27±440.49) pg/ml, (529.98±222.43)U/L and (191.92±119.42)/μl, (87.33±50.59)/μl and (106.92±87.42)/μl at admission and (69.58±50.21) pg/ml, (285.38±46.62 U/L), (888.58±672.99)/μl, (336.83±305.21)/μl and (520.08±388.76)/μl at discharge.The differences were statistically significant ( P<0.001, P=0.002, 0.006, 0.017, 0.005). All of them received compound sulfamethoxazole and caspofungin.Except for one death due to septic shock after 21-day treatment, 12 cases were cured. Conclusions:mNGS test is one of the important tool for an early diagnosis of PCP.Combined use of compound sulfamethoxazole and caspofungin is an effective anti-infective regimen.And immune function monitoring is vital for adjusting antibiotic and immunosuppressive regimens.

Objective To deduce the normal range of thyroglobulin ( Tg ) of adults senum in Liaoning Province . Methods From February to November 2017 , in Kangping County of Shenyang ( inland group ) and Gaizhou City of Yingkou (coastal group), the Tg levels of adults in different age groups were investigated according to the cluster stratified sampling method. Adults were divided into young (18 - 44 years old), middle (45 - 59 years old ) , and elderly (≥60 years old ) groups , and fasting blood samples were collected . Levels of Tg , thyroid function [ thyroid stimulating hormone (TSH), free triiodothylaminogenic acid (FT3), free thyroxine ( FT4 ) ] , thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were determined by automatic electrochemiluminescence immunoassay analyzer. Statistical analysis was performed on Tg measured values of normal thyroid function and antibody-negative adults, and the percentile range (P2.5 - P97.5) was used to calculate the 95％ normal range of both sides. Results A total of 685 adults were included, with a Tg level of 9.86 μg/L, including 333 adults in the inland group with a Tg level of 8.97 μg/L, and 352 adults in the coastal group with a Tg level of 10.44 μg/L. There were 255 males and 430 females, Tg levels were 9.39 and 9.99 μg/L, respectively. There were 179, 307 and 199 adults in the young, middle and elderly groups, Tg levels were 8.84, 9.22, and 11.73 μg/L, respectively, the differences were statistically significant (H=9.607, P<0.05). The normal range of Tg in adults was 1.23-58.63μg/L, and the normal ranges of Tg in the young, middle and elderly groups were 1.62 - 41.90, 0.99 -54.58, and 0.94 - 85.78 μg/L, respectively. Conclusion Successful establishment of the normal range of adults serum Tg in Liaoning Province.

Objective To detect the viscoelasticity of carotid artery in healthy volunteers using ultrasonic shear wave dispersion ( SWD ) technique ,and explore the feasibility and influencing factors for SWD parameters . Methods Forty‐five healthy volunteers were recruited and divided into elder group ( ≥50 years old) and younger group ( ＜50 years old) according to the age . T he carotid arteries were examined by SWD at systole ,axial elastic modulus ( SWER ) and viscous index ( SWDR ) were obtained . T he pulse wave velocity ( PWV ) ,a carotid artery circumferential elastic parameter was obtained and considered as the reference indicator . T he difference of SWE R ,SWDR and PWV were compared between two groups ; and the correlation between them were analyzed by Pearson analysis ,respectively . Results ① Compared with the younger group ,the carotid PWV increased ,w hile SWE R and SWDR decreased in the elder group ( all P ＜0 .05) . ②In all subjects ,SWER was negatively correlated with PWV ( r ＝ －0 .256 , P ＜ 0 .05 ) . In the elder group ,SWER was negatively correlated with systolic blood pressure ( r ＝ －0 .357 , P ＜ 0 .05 ) ,and SWDR was negatively correlated with PWV ( r ＝ －0 .393 , P ＜0 .05 ) . In the younger group ,SWDR was positively correlated with systolic blood pressure ( r ＝0 .366 , P ＜0 .05) . Conclusions Compared with the elder group ,the carotid viscoelasticity was higher in young people ,and it is correlated with PWV . SWD can evaluate carotid viscoelasticity ,and contribute to better understanding of its tissue characteristics .

Objective: To detect the viscoelasticity of carotid artery in healthy volunteers using ultrasonic shear wave dispersion (SWD) technique, and explore the feasibility and influencing factors for SWD parameters. Methods: Forty-five healthy volunteers were recruited and divided into elder group (≥50 years old) and younger group (<50 years old) according to the age. The carotid arteries were examined by SWD at systole, axial elastic modulus (SWE_R) and viscous index (SWD_R) were obtained. The pulse wave velocity (PWV), a carotid artery circumferential elastic parameter was obtained and considered as the reference indicator. The difference of SWE_R, SWD_R and PWV were compared between two groups; and the correlation between them were analyzed by Pearson analysis, respectively. Results: ①Compared with the younger group, the carotid PWV increased, while SWE_R and SWD_R decreased in the elder group(all P<0.05). ②In all subjects, SWE_R was negatively correlated with PWV (r=-0.256, P<0.05). In the elder group, SWE_R was negatively correlated with systolic blood pressure (r=-0.357, P<0.05), and SWD_R was negatively correlated with PWV (r=-0.393, P<0.05). In the younger group, SWD_R was positively correlated with systolic blood pressure (r=0.366, P<0.05). Conclusions Compared with the elder group, the carotid viscoelasticity was higher in young people, and it is correlated with PWV. SWD can evaluate carotid viscoelasticity, and contribute to better understanding of its tissue characteristics.

Objective To master the prevalence of drinking-water-borne endemic fluorosis of children in the disease affected areas of Liaoning Province and to understand the effect of water improvement measures in prevention and control of fluorosis.Methods The data of 18 water improvement projects in drinking-water-borne endemic fluorosis areas of Liaoning Province from 2011 to 2016 were collected by retrospective method,and the data of dental fluorosis in children aged 8 to 12 years old were analyzed.The prevalence and detection rate of dental flaorosis in children aged 8 to 12 years old were analyzed.To compare the incidence of dental fluorosis among children from villages with qualified water fluoride and those from villages with unqualified water fluoride.Results From 2011 to 2016,in the annual survey of 18 water engineering projects in 18 monitored villages,normal operating rate was between 94.44％ (17/18)-100.00％ (18/18),water fluoride qualified rate was between 88.89％ (16/18)-100.00％ (18/18).In the monitored village,4 941 children aged 8 to 12 were examined,and the detection rate of dental fluorosis was 9.8％ (484/4 941).The dental fluorosis index was 0.19.The detection rate (14.0％,10.7％,10.7％,8.7％,6.6％,8.1％) of dental fluorosis was decreasing year by year (x2trend =24.3,P ＜ 0.05).The total detection rate of children's dental fluorosis in monitored villages (8.1％,356/4 422) with normal operation of water improvement projects and qualified water fluoride was lower than that in monitored villages with excessive water fluoride (24.7％,128/519,x2 =145.1,P ＜ 0.05).Conclusion After water improvement measures are implemented in drinking water fluorosis areas of Liaoning Province,the dental fluorosis of children in the affected areas is effectively controlled,but the problem of excessive fluoride in water improvement projects still exists,and the management of water improvement projects should be strengthened in the future.

Objective To study the antidepressant effect of subanesthestic dose ketamine in anesthesia after cesarean section. Methods One hundred and twenty-six parturients who had underwent cesarean section were divided into ketamine group and control group with 63 cases each, The parturients in control group were given intravenous 0.9%sodium chloride 20 ml after childbirth, and the parturients in ketamine group were given subanesthetic dose ketamine after childbirth (0.5 mg/kg + 20 ml 0.9%sodium chloride). The parturients were evaluated by hospital anxiety and depression scale (HADS) and postpartum depression screening scale (PDSS). Results The scores of HADS and PDSS 5 and 10 d after parturition in ketamine group were significantly lower than those in control group, HADS:(7.67 ± 2.53) scores vs. (10.48 ± 2.48) scores and (7.96 ± 2.61) scores vs. (11.24 ± 2.74) scores, PDSS:(52.58 ± 13.36) scores vs. (71.34 ± 15.19) scores and (53.73 ± 13.28) scores vs. (73.41 ± 15.37) scores, and there were statistical differences (P<0.01). The incidences of depression 5 and 10 d after parturition in ketamine group were significantly lower than those in control group:4.8%(3/63) vs. 15.9%(10/63) and 4.8%(3/63) vs. 17.5% (11/63), and there were statistical differences (P<0.05). There were no serious adverse reactions in the 2 groups. Only 2 cases had mild nausea in control group, and the symptoms disappeared after adjustment. Conclusions The use of subanesthestic dose ketamine can significantly reduce the incidence of postoperative depression in cesarean section, and it has a good antidepressant effect.

AIM: To investigate the effect of peripheral administration of arginine vasopressin (AVP) on lipopolysaccharide (LPS)-induced fever and hyperalgesia in rats and its relationship with interleukine-1β (IL-1β) and prostaglandin E2 (PGE2).METHODS: The core temperature (Tc), brown adipose tissue (BAT) temperature and activity were measured by telemetry in adult male Sprague-Dawley rats at an ambient temperature of 23 ℃ during a 12 h light/12 h dark photoperiod (lights on at 06:00 and lights off at 18:00).The rats were intraperitoneally injected with LPS (50 μg/kg), AVP (10 μg/kg) or V1a vasopressin receptor antagonist (V1a antagonist, 30 μg/kg) at 10:00 or 11:30.Hyperalgesia was assessed by measuring the latency to withdraw a hindpaw from radiant heat (Hargreaves test).The concentrations of IL-1β and PGE2 in the serum were tested by ELISA.RESULTS: Intraperitoneal administration of LPS induced periods of biphasic fever accompanied by hyperalgesia.AVP reversed LPS-induced fever, and decreased the hyperalgesia and BAT thermogenesis.Peripheral administration of V1a antagonist enhanced the fever produced by LPS, but did not affect the hyperalgesia.AVP significantly attenuated LPS-induced IL-1β and PGE2 production.CONCLUSION: Peripheral administration of AVP reverses LPS-induced fever and decreases hyperalgesia by reduction of BAT thermogenesis and inhibition of IL-1β and PGE2.Endogenous AVP attenuates the fever induced by LPS, but does not affect the nociceptive thresholds.