Objective:To explore the differential expression profile of miRN in the development of diabetes nephropathy (DN), and further explore the mechanism of miR-126-5p involved in high glucose induced injury of renal tubular epithelial cells.Methods:Firstly, we downloaded existing chip data from the Gene Expression Integrated Database (GEO) and used GEO2R, miRanda, gene ontology (GO) analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis to mine differential miRNAs. Subsequently, a high glucose induced HK-2 cell injury model was used and divided into three groups: high glucose model group, si-HOTAIR group, and si HOTAIR+ miR-126-5p inhibitor group. The three groups of cells were sequentially transfected with siRNA-NC, siRNA-HOTAIR, and siRNA-HOTAIR+ miR-126-5p mimic, and cultured in a medium containing 60 mmol/L glucose. Flow cytometry was used to detect changes in apoptosis levels in each group, while cell counting kit-8 (CCK-8) was used to detect changes in cell proliferation.Results:Through data mining analysis using GEO, it was found that compared to ordinary mice, DN mice had 74 upregulated miRNAs and 80 downregulated miRNAs in their kidney tissue. Enrichment analysis results showed that miRNAs could target signaling pathways such as Wnt, PKG, MAPK, and Rap1, and miR-126-5p was significantly downregulated. In the high glucose induced HK-2 cell injury model, the experimental results showed that the inhibitory effect on cell proliferation activity was more significant at a high glucose concentration of 60 mmol/L ( P<0.05); High glucose stimulation significantly reduced the expression of miR-126-5p ( P<0.05). The results of flow cytometry showed that compared with the high glucose model group, the apoptosis rate of the si-HOTAIR group significantly decreased ( P<0.05), while the apoptosis rate of the si-HOTAIR+ miR-126-5p inhibitor group significantly increased ( P<0.05). The CCK-8 experiment showed that compared with the high glucose model group, the cell viability of the si-HOTAIR group significantly increased ( P<0.05); The cell viability of the si-HOTAIR+ miR-126-5p inhibitor group was inhibited ( P<0.05). Conclusions:miR-126-5p can inhibit high glucose induced apoptosis in HK-2 cells and protect them.

Objective:To explore the value of cardiac MRI (CMRI) in evaluating left atrial function in patients with postoperative tetralogy of Fallot (rTOF) and postoperative pulmonary stenosis (rPS).Methods:Totally 67 pediatric patients (49 with rTOF, 18 with rPS) with preserved left ventricular ejection fraction (EF) were recruited between January 2019 and October 2021 in Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University. Thirty-three healthy volunteers, matched in gender and age, were included as controls from July 2017 to August 2018. Left atrial EF, strain and strain rate of three phases (reservoir, conduit and pump), left atrial volume (maximum volume index, minimum volume index and pre-atrial contraction volume index) were measured with corresponding cardiac function analysis software. Then, the differences in these parameters were analyzed between the three groups by ANOVA or Kruskal-Wallis test with post hoc comparison and Bonferroni correction.Results:Compared with controls, patients with rTOF had lower reservoir function parameters (EF, strain and strain rate), conduit EF, conduit strain, and left atrial maximum volume index ( P<0.05), but higher pump EF ( P<0.05). In patients with rPS, only the reservoir strain rate decreased compared with controls ( P<0.05), and the remaining data showed no significant difference ( P>0.05). The reservoir and conduit EF and strain in patients with rPS were higher than those in patients with rTOF ( P<0.05). Conclusions:In patients with rTOF and rPS, left atrial function has changed despite the preservation of left ventricular EF, which may be an early marker of left ventricular diastolic dysfunction. In children with rTOF, left atrial reservoir and conduit functions decreased while the pump function increased. The reservoir and pump functions in rPS were better than those in rTOF. In addition, CMRI can detect left atrial dysfunction early before it enlarged.

Objective:To explore the characteristics of intestinal flora in female patients with type 2 diabetes mellitus (T2DM) with comorbid coronary heart disease.Methods:Female patients with T2DM from September 2019 to November 2020 were enrolled in this study and divided into 2 groups stratified by coronary heart disease: 22 patients with coronary heart disease(T2DM+ CHD group) and 49 patients with simple T2DM group(T2DM group). Thirty-one healthy females were selected as the normal control group(NC group). The abundance of intestinal flora, the difference in intestinal flora and its relationship with indicators such as glycosylated hemoglobin and fasting blood glucose was analyzed by the real-time fluorescent quantitative PCR detection technology in the three groups.Results:The abundance of Prevotella in the T2DM group was lower, and Roseburia inulinivorans and Faecalibacterium prausnitzii in the T2DM+ CHD group were lower, while Bacteroides and Enterococcus spp in the T2DM+ CHD group were higher compared with NC group, respectively( P<0.05). The abundance of Bacteroides and Enterococcus spp in the T2DM+ CHD group was lower than that in the T2DM group( P<0.05). Spearman correlation analysis showed that the abundance of Faecalibacterium prausnitzii and Eubacterium rectale was negatively correlated with obesity while abundance of Bacteroides and Enterococcus spp was positively correlated with HbA 1C and fasting blood glucose. The abundance of Bacteroides was positively correlated with TCH and TG(all P<0.05). Logistic regression analysis showed that Bacteroides and Enterococcus spp were independent influencing factor of the development of female patients with T2DM and CHD. Conclusion:Female T2DM and T2DM with CHD had intestinal flora imbalance, which was related to a variety of glucose and lipid metabolism indicators, and might be closely related to the occurrence of T2DM and CHD. Bacteroides and Enterococcus spp were independent influencing factors of the development of female patients with T2DM and CHD. Regulating the intestinal flora can provide ideas for the prevention and treatment of T2DM with CHD in female.

This article reported a male neonate with Smith-Lemli-Opitz syndrome (SLOS) caused by DHCR7 gene compound heterozygous variations. The patient presented with multiple malformations and feeding difficulties after birth and was transferred to the First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital) from a local hospital eight days later. Physical examination found general scleredema, scalp defects, short penis, urinary tract malformation, bilateral syndactyly of the second and third toes, and low serum cholesterol. Whole-exome and Sanger sequencing indicated a compound heterozygous mutation in the DHCR7 gene, c.852C>A(p.F284L), and a de novo mutation of c.820_825del(p.N274_V275del). SLOS is rare in the Asian populations and prone to missed diagnosis and misdiagnosis with difficulty in clinical management. The possibility of SLOS should be considered for newborns with multiple malformations and low serum cholesterol.

Objective:To investigate the value of whole-heart and volume-targeted balanced steady-state free precession(bSSFP) in the evaluation of coronary artery in children.Methods:Children with congenital heart disease and Kawasaki disease who underwent cardiac magnetic resonance imaging were retrospectively collected from January 2014 to December 2015, 197 cases(male: female 124∶73) were included according to the inclusion and exclusion criteria in this study. There were 189 cases of congenital heart disease and 8 Kawasaki disease, in which 23 cases had abnormal coronal arteries. Image quality of the coronary artery segments, the coronary artery origin and course, and coronary artery dimension in dual phase 3D bSSFP were analyzed. Chi-square test was used to evaluation the degree of accuracy and difference of coronal artery segments. T test was used to compare the diameter of left with right coronal artery in end systolic phase and mid to end diastolic phase.Results:Image quality was better in systolic phase than diastolic phase(3.9±0.5 and 3.5±0.7 respectively, P<0.001) for all cases. Combining the dual phases, the sensitivity, specificity and accuracy of dual phase 3D whole heart imaging in evaluating the coronal artery origin, course and shape was 100%. However, there was a little difference in revealing left anterior descending coronary artery, left circumflex artery and right coronary artery. There was significant difference in the clearly revealing the left anterior descending coronary artery and left circumflex artery( P<0.001). The left and right coronary artery dimension was larger in systolic phase than in mid-diastolic phase(left coronary artery 3.1±1.3 mm and 2.8±1.3 mm, respectively, right coronary artery(2.5±0.9) and(2.3±0.7)mm, respectively, P<0.001). Conclusion:Cardiac MR 3D bSSFP can retrospectively select coronary resting periods for optimal images, providing a more reliable imaging modality for the assessment of coronary arteries in children to make better clinical decision.

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7–18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959– 0.991; p < 0.001) as well as right (0.755–0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

【Objective】 To analyze the viability of covering blood cost in medical insurance in China and discuss the necessity and practicability, so as to provide references for the improvement of medical insurance mechanism. 【Methods】 A questionnaire was designed and issued to blood centers covering 31 provinces /municipalities/autonomous regions in June 2019, and respective information regarding basic medical diagnosis and treatment directory, as well as normative documents on the official websites was collected and analyzed. 【Results】 13 out of 31 provinces /municipalities/autonomous regions had introduced the relevant policies of covering blood cost in medical insurance. Concerning the other 18 respondents, a total of 52 cities in 9 provinces had issued relevant policies. 5.01 billion RMB was included in medical insurance in 2017, accounting for 61.00% of the total clinical blood cost. 【Conclusion】 Less economic burden and less impact on voluntary blood donation recruitment could be realized by setting clinical blood price by the government.

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7–18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959– 0.991; p < 0.001) as well as right (0.755–0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

Objective:To evaluate the feasibility of cardiac MRI three dimensional (3D) balanced steady state free precession (b-SSFP) cine imaging in evaluating cardiac function in children with repaired tetralogy of Fallot (TOF).Methods:Thirty children with repaired TOF underwent cardiac MRI examination at Shanghai Children′s Medical Cent er Affiliated to Shanghai Jiao Tong University School of Medicine, were retrospectively collected from April 2018 to October 2019. From June 2017 to August 2018, 10 healthy children were enrolled. Cardiac images of subjects were obtained using both two dimensional (2D) b-SSFP and 3D b-SSFP cardiac cine MRI and the total acquisition time was recorded. The image quality was scored using a 5-point scale, with a score≥3 as diagnostic image quality. The left and right ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), cardiac output (CO), and cardiac index (CI) were measured. The left and right ventricle parameters were compared using paired ttest or Wilcoxon test. The Pearson correlation or Spearman correlation analysis were used to evluate the correlation between the parameters measured with the 2 methods. Results:The acquisition time of 2D b-SSFP images was (426.5±13.0) s, and the total time of 3D b-SSFP images was (24.7±2.5) s. The 2D b-SSFP image quality score was better than 3D b-SSFP, and the differences were statistically significant (TOF patients: Z=-3.879, P<0.001; volunteers: Z=-2.646, P=0.003). All 2D and 3D b-SSFP image quality scores were ≥ 3 points, which can be used for clinical diagnosis. There were no statistically significant differences in cardiac function parameters between two series measurements in both TOF patients and volunteers ( P>0.05). For TOF patients, the left ventricular EDV, ESV, SV, EF, CO and right ventricular EDV, ESV, and SV showed highly positive correlation ( r>0.8, P<0.05). For volunteers, the left ventricular EDV, ESV, SV and right ventricular EDV and SV showed highly positive correlation ( r>0.8, P<0.05). Conclusion:Compared with the 2D b-SSFP sequence, 3D b-SSFP sequence with fairy good image quality can meet the diagnostic requirement and can accurately measure the cardiac function with shorter acquisition time. The 3D b-SSFP has a good application prospect in pediatric cardiac MRI.

Objective ToexplorethevalueofMRIinthediagnosisofcoronaryarteryandmyocardiallesionsinchildrenwithKawasaki disease.Methods CardiacMRIof38patientswithKawasakidiseasewereretrospectivelyanalyzed.MRIsequencesincludedthree dimensionalsteady-statefreeprecession (3D-SSFP)coronaryarteryimaging,first-passperfusiontoassessmyocardialischemia,late gadolinium-enhancedmagneticresonanceimaging(LGE-MRI)toassessmyocardialhistologyfeatures,and2D-SSFPcinesequenceto evaluatecardiacfunction.Themaximumdiametersofcoronaryaneurysmsmeasuredin3D-SSFPwerecomparedwiththosemeasured inechocardiography(ECHO)byBland-Altmananalysis.Results Amongthe38cases,therewere28cases(73.7%)withaneurysmal dilatationinrightcoronaryartery(RCA)orleftcoronaryartery (LCA).Thehighestincidenceofaneurysmaldilatationwasinleft anteriordescendingbranch (LAD)in23cases,andfollowedbyRCAin19cases.ThemaximumdiameterofRCAaneurysm (7.66± 2.10)mm washigherthanthatofLADaneurysm (6.11±1.96)mm withP＜0.05.Myocardialfirst-passperfusionin5casesshowed leftventricularandventricularseptumsubendocardialischemia,LGE-MRIin5casesshowedmyocardialdelayedenhancementinleft ventricularfreewallandventricularseptum,andtheleftventricularejectionfractionsin4caseswerelessthan50%,withanaverage of(34.0±15.9)%.3D-SSFPandECHOshowedgoodconsistencyinthemaximaldiametermeasurementofRCAandLADaneurysm. Conclusion TheimagingfeaturesindifferentsequencesofMRIcanbeusedtocomprehensivelyevaluatethecoronaryarteryand myocardialhistologicalcharacteristicsofKawasakidisease,includingcoronaryaneurysms,thrombosis,myocardialfibrosisandchanges ofventricularfunction.