Coronary artery fistula(CAF)is defined as the direct connection between coronary artery and cardiac cavity,great vessel or other vascular structures.Most CAF are congenital and often present as persistent murmur in asymptomatic children.Although abnormal shunt of most coronary fistulas has little effect on hemodynamics,some larger fistulas can also lead to a series of complications,such as congestive heart failure.Therefore,closed CAF has been recommended to treat or prevent myocardial ischemia,congestive heart failure,endarteritis,arrhythmia,thromboembolism,aneurysm dilatation and rupture and other complications.CAF is a rare congenital heart disease,and bilateral CAF originating from two coronary arteries is even rarer.At present,there are rare systematic reports on bilateral CAF.Therefore,a case of huge bilateral CAF at the same site was reported,and systematically,this kind of case was summarized,so as to improve the clinical attention of diagnosis and treatment of this kind of CAF.Nowadays,some new interventional devices and technologies are emerging with the continuous progress of cardiovascular interventional technology,making the treatment more accurate,safe and effective.At the same time,there is also a clearer understanding of the indications and operating standards for interventional treatment,which is more operable and predictable during the treatment process.Therefore,interventional treatment of CAF may partially replace surgical treatment as the preferred treatment method.

Objective: To establish a GDH-3 air sample tube for simultaneous determination of twelve kinds of chlorobenzene compounds (CBs) in workplace air by gas chromatography. And to established a matching determination method. Methods: In October 2020, the vapor and aerosol CBs in workplace air were collected by GDH-3 air sampling tube, and desorption and elution with 3.00 ml toluene for 15 min, then the solution separated by DB-23 capillary column, and finally detected with microcell electron capture detector. Results: The quantitative determination ranges of twelve isomers of CBs were 0.71×10(-3)-2000.00 mg/L, with the correlative coefficients were 0.99967-0.99998. The minimum detectable concentrations were 0.04-112.63 μg/m(3), and the minimum quantification concentrations were 0.14-375.42 μg/m(3) (15.00 L sample, 3.00 ml sample solution) . The average elution efficiencies were 96.00%-104.00%. The within-run relative standard deviations (RSDs) were 2.54%-6.12%, and the between-run RSDs were 3.85%-7.87%. Sealed samples could be stable at room temperature for at least 15 days. Conclusion: GDH-3 air sample tube can be used for simultaneous determination of twelve kinds of CBs in workplace air by gas chromatography. The established supporting measurement method meets the measurement requirements of the occupational health standard detection method, and the it's suitable for the simultaneous determination of 12 kinds of CBS in the air.
Air Pollutants, Occupational/analysis* ; Chlorobenzenes/analysis* ; Chromatography, Gas/methods* ; Research ; Workplace

BACKGROUND: Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China. METHODS: The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD. RESULTS: A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05). CONCLUSION Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.
Birth Weight ; Bronchopulmonary Dysplasia ; China/epidemiology* ; Delivery Rooms ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Extremely Premature ; Infant, Newborn ; Male ; Pregnancy

Objective To explore the effects of magnesium sulfate in combination with astragalus membranaceus injection on the birth outcomes and expression of placenta tissue related gene of patients with gestational hypertension. Methods Seventy-six gestational hypertension patients were selected and randomly assigned to control group (n = 38) and treatment group (n = 38). The control group was given intravenous injection of 25％ magnesium sulfate (60 mL) once daily for 7 days,while the treatment group was give intravenous injection of astragalus (60 mL) on the basis of the control group once daily for 7 days. The changes of blood pressure,mean arterial pressure (MAP) and 24 h urine protein content of the two groups were compared. The placenta tissue of the two groups were collected after childbirth. Results After treatment,the total effective rates of the control group and the treatment group were86. 84％ (33/38) and 97. 37％ (37/38) ,respectively; the difference was statistically significant (P < 0. 05). There were significant differences between the control group and the treatment group in systolic blood pressure [(147. 21 ± 20. 01) mmHg vs (128. 46 ± 18. 43) mmHg],diastolic blood pressure [(90. 25 ± 15. 46) mmHg vs (73. 14 ± 14. 53) mmHg],MAP [(126. 76 ± 9. 65) mmHg vs (108. 15 ± 9. 57) mmHg] and the 24 h urine protein content [(2. 65 ±0. 87) g vs (1. 34 ±0. 79) g](P < 0. 05). Conclusion Magnesium sulfate combined with astragalus membranaceus injection can reduce the blood pressure of gestational hypertension patients,improve the pregnancy outcome; the action mechanism maybe related to the up-regulation of PLGF and MMP-9 protein expression of placenta tissue.

Objective To investigate the effect of puerarin on oxidative stress and immune status in placenta of preeclampsia (PE) rats. Methods Forty-five pregnant female SD rats were randomly divided into control group,model group and test group,15 rats in each group. The rats in model group and test group were subcutaneously injected with 100 mg·kg-1 of L-arginine methyl ester (L-NAME) once daily from Day 13-21 of gestation,the rats in control group were injected with the same amount of saline; and the rats in test group were intraperitoneally injected with 80 mg·kg-1 of puerarin solution once daily from Day 17-21 of gestation,control group and model group were injected with the same amount of 0. 9％ NaCl. The caudal arterial pressure and 24 h urinary protein content were measured at Day 10,16 and 21 of gestation,the oxidative stress indexes in rat placenta was detected by thibabituric acid method and Xanthine oxidase method,the cellular immune function was detected by flow cytometry,and the X-linked inhibitor of apoptosis protein (XIAP) expressionin of rat placenta trophoblasts was detected by Western blot. Results On Day 21 of gestation,there were significant differences between the model group and the control/test group in caudal arterial pressure [(136. 25 ± 5. 48) mm- Hg vs (119. 25 ± 4. 21) mmHg or (123. 52 ± 6. 45) mmHg],24 h-urinary protein contents [((11. 83 ± 0. 12) mg vs 6. 42 ± 0. 08) mg or (8. 58 ± 0. 12) mg],the content of MDA in placenta tissue [(4. 75 ± 0. 08) mmol·mg-1 vs(10. 69 ± 0. 07) mmol·mg-1,(8. 37 ± 0. 08) mmol·mg-1 ],the content of SOD [(93. 26 ± 4. 29) U·mg-1 vs(168. 97 ± 3. 42) U·mg-1 or (112. 63 ± 3. 48) U·mg-1 ],the ratio of CD4 +/CD8 + [(2. 61 ± 0. 56) vs(1. 46 ± 0. 05) or (1. 48 ± 0. 12) ] and the relative expression of XIAP protein in trophoblast [(0. 89 ± 0. 05) vs(0. 36 ± 0. 09) or (0. 41 ± 0. 11) ](all P < 0. 05). Conclusion Puerarin can inhibit the oxidative stress reaction and enhance the cellular immune function in the placenta of PE rats,and reduce the expression of XIAP protein in the placenta tissue trophoblasts to reduce the apoptosis of placenta trophoblasts.

Objectives:The purpose of this study was to explore the relationship between the of pericardial adipose tissue (PAT) volume and cardiovascular disease risk factors and energy consumption. Methods:From September 2014 to December 2015,we enrolled 152 inpatients underwent coronary artery CT examination due to suspected coronary heart disease in the Hospital on Integration of Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine.The volume of PAT was assessment by 64-slice CT, the energy consumption was assessment by the International Physical Activity Questionnaire. The clinical data, biochemical indexes, PAT volume were analyzed. Results : (1) PAT volume was significantly correlated with age, gender, BMI, HOMA-IR, FPG, HDL-C, TG, total physical activity energy consumption, total middle intensity physical activity energy consumption, total energy consumption of sedentary (P<0.05 or P<0.001); (2) PAT volume of patients with insulin resistance was significantly higher than those without insulin resistance; (3) Multiple regression analysis revealed that age, gender, BMI, total middle intensity physical activity energy consumption were independent predictors of PAT volume. Conclusions: Pericardial adipose tissue (PAT) volume is associated with age, gender, systolic blood pressure, BMI, total middle intensity physical activity energy consumption.

Objective To express the recombinant IL-37b protein and to investigate its role in the regulation of immune responses. Methods The prokaryotic expression vector pET28/IL-37b was constructed. The recombinant IL-37b protein was induced to be expressed and was purified using Ni2+-NTA gel column. C57BL/6 J mice were treated with IL-37b and injected with lipopolysaccharide(LPS)to induce septic shock,and the expression levels of IL-1β,IL-6,IFN-γ in the serum of the mice were detected. Dendritic cells from bone marrow of the mice were isolated and cultured, and were treated with IL-37b. After LPS-induced activation, the expression levels of marker molecules such as CD40, CD80 and MHCII on the cell surface, and cytokines such as IL-1β, IL-10, IL-12 and TNF-α in the culture supernatants were detected by flow cytometry. The CD4 +T cells from mice were isolated and the inhibitory effects of IL-37b on the expression of IFN-γ,TNF-α and IL-10 in the culture supernatants of T cells after induction by LPS were detected. Results IL-37b reduced the expression levels of proinflammatory cytokines in the serum of septic shock mice. IL-37b also inhibited the expression of co-stimulatory molecules and proinflammatory cytokines of the mouse dendritic cells, and suppress the activation of CD4 +T cells in vitro. Conclusions Purified recombinant IL-37b protein has high bioactivity, and can alleviate septic shock in organisms through inhibiting the activation of dendritic cells and related T cell immune responses.

OBJECTIVETo determine the changes in the airway inflammation-related cytokine/chemokine profiles after exposure to cigarette smoke (CS) and smoking cessation (SC).

METHODSA total of 18 male C57BL/6 mice were equally divided into three groups: CS group, SC group, and normal control group. The airway resistance, lung morphology, and collagen deposition around airways were determined. HE staining and Masson trichrome staining were used for histopathological analysis. The inflammatory cells in bronchoalveolar lavage fluid (BALF) were assessed. The inflammation-associated cytokines were determined using real-time PCR and immunohistochemistry. Expressions of CXCR3 ligands including the CXCL9, CXCL10, CXCL11 and other cytokines in lung tissue and BALF were also analyzed.

RESULTSThe airway resistance significantly increased in both CS group and SC group when compared with the normal control group. Lung pathological scores in both CS group and SC group were also higher than that in the normal control group, while there was no significant difference between the CS group and SC group. Inflammatory cells including the neutrophils, macrophages, and lymphocytes also increased in both the CS group and SC group at both mRNA and protein levels. The mRNA levels of CXCL9, CXCL10, MMP9, and MMP12 were significantly higher in CS group and SC group than those in the normal control group (all P<0.05). The protein expression levels of CXCL9, CXCL10, CXCL11, MMP2, MMP9, MMP12, and TGF-Β1 were significantly higher in CS group and SC group than those in the normal control group (all P<0.05). Compared with the normal control group,the concentrations of CXCL9, CXCL10, CXCL11, IL-8, and TGF-Β1 in the BALF supernatants of the CS group and SC group significantly increased (P<0.05); in addition, the IL-6 and TNF-Α concentrations also increased in the CS group (both P<0.05).

CONCLUSIONSCS exposure triggers inflammatory cell flux and accumulation in the lung parenchyma and BALF. As a consequence, the inflammatory cytokines increase dramatically. After CS, the cytokines/chemokines can decrease, but is still higher than in non-smokers.

Animals ; Chemokines ; metabolism ; Cytokines ; metabolism ; Lung ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Smoking Cessation ; Tobacco Smoke Pollution

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications

BACKGROUNDA multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions. Some researchers believe that 6 L/d is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.

METHODSAdult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices.

RESULTSChanges of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr). Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR). Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L×1.73 m(-2)×w(-1). More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that.

CONCLUSIONSThe domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution. During 48-week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.

Adolescent ; Adult ; Aged ; Dialysis Solutions ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis ; methods ; Young Adult