【Objective】 To compare the degree, efficacy and safety of testicular catch-up growth after inguinal and subinguinal surgery for adolescent varicocele. 【Methods】 Clinical data of 121 adolescent varicocele patients with secondary testicular atrophy treated during Sep.2014 and Jun.2021 at Huili People’s Hospital were retrospectively analyzed, including 40 cases treated with the inguinal incision approach, and 81 with the subinguinal approach. The characteristics of intraoperative, efficacy, surgical complications and prognosis were compared between the two groups. 【Results】 The inguinal group had significantly shorter microscope usage time (P=0.006), fewer number of preserved internal spermatic arteries (P<0.001), and significantly larger diameter of preserved internal spermatic arteries than the subinguinal group (P=0.005). The subinguinal group required ligation of more internal spermatic veins, and there were significantly more internal spermatic veins with a diameter of 4 mm or more (P<0.001). No recurrence occurred, and the incidences of scrotal edema and hydrocele were very low (P>0.05). Two years after surgery, the bilateral testicular volume of both groups was significantly larger than that before surgery (P<0.05), and there was no significant difference in the testicles (P>0.05). 【Conclusion】 In the treatment of adolescent varicocele patients with secondary testicular atrophy, the subinguinal approach significantly reduces the difficulty of microsurgical varicocele ligation, and has good efficacy and safety, which is worthy of clinical promotion and application.

Objective:To explore the clinical application and effect of FilmArray ? meningitis/encephalitis (ME) panel in identifying pathogens of central nervous system (CNS) infections in children. Methods:Molecular biology study.Cerebrospinal fluid (CSF) samples were prospectively obtained through lumbar puncture from children with suspected CNS infections admitted to the Department of Infectious Diseases at Beijing Children′s Hospital, Capital Medical University from May to November 2019.These samples were subjected to both routine clinical pathogen testing and FilmArray ME panel testing.Polymerase chain reaction was used to validate all samples.Independent sample t-test or Mann-Whitney U-test was used for comparative analysis of the results and influence factors obtained by the two detection methods. Results:A total of 113 cases of suspected CNS infections were enrolled.Routine clinical testing yielded 17 cases, with a positive rate of 15.0%, including 4 positive CSF cultures, with a positivity rate of 3.5%.FilmArray ME panel detected 23 positive cases, with a positive rate of 20.4%.FilmArray ME panel detected bacteria in 7 cases, viruses in 13 cases, fungi in 1 case, and both viruses and bacteria in 2 cases.Among the common pathogens detected, FilmArray ME panel obtained the results on average 2.7 days in advance.Conclusions:Compared with CSF culture, FilmArray ME panel has the advantages of shorter detection period, higher positive detection rate, and higher virus detection rate.

Objectives:To investigate whether circumferential pulmonary vein isolation(CPVI)combined with additional ablation reduces the recurrence rate of atrial fibrillation(AF)compared with CPVI alone. Methods:A literature search was conducted using the databases CNKI,Wanfang Data,VIP,Chinese Biomedical Literature Database,PubMed,Embase,the Cochrane Library.Randomized controlled studies that met the standards in recent ten years were screened,and the relevant literature contents were meta-analyzed by Review Manager 5.3 software.The comparison results of CPVI alone with CPVI combined with the additional ablation strategies in the recurrence of AF were summarized. Results:A total of 21 literatures were included with 3 357 patients,of whom 1 580 underwent CPVI alone and 1 777 underwent CPVI combined with additional site ablation.The follow-up time was more than 1 year.Meta-analysis showed that there was no significant difference between CPVI alone and CPVI combined ablation strategies in reducing AF recurrence(OR=0.86,95%CI:0.73-1.01,P=0.06).Subgroup analysis based on additional ablation site,AF type,left atrial diameter,and AF diagnosis time showed that only in the small left atrial diameter subgroup,CPVI combined with additional ablation further reduced the recurrence rate of AF(OR=0.68,95%CI:0.47-0.98,P=0.04). Conclusions:The ablation strategy of CPVI combined with additional sites could not reduce the recurrence rate of AF compared with CPVI alone.

Objective To explore the relationships of MRI manifestations of pericruciate ligament fat pad(PCFP)with the severity of knee osteoarthritis(KOA).Methods Fifty patients with MRI diagnosed KOA(KOA group)and 30 healthy subjects(control group)were retrospectively included.Signal intensity changes of PCFP,infrapatellar fat pad(IPFP),quadriceps fat pad(QFP)and prefemoral fat pad(PFP)were observed,and the maximum cross-sectional areas were obtained.The severity of KOA was assessed,including knee cartilage injury,anterior cruciate ligament tear,bone marrow lesion(BML),meniscal injuries and Park classification.MRI parameters of fat pad were compared between groups,and correlations of PCFP MRI parameter and other fat pad MRI parameters with the severity of KOA were analyzed.Results Signal change grade of IPFP and PCFP were significant different between groups(both P＜0.05),and the maximum cross-sectional area of IPFP and the thickness of PFP patellofemoral in KOA group were smaller than,while the maximum cross-sectional area of PCFP in KOA group was larger than that in control group(all P＜0.05).The signal change grade of PCFP was positively related to signal change grade of IPFP(rs=0.557)but negatively related to PFP interpatellofemoral thickness(rs=-0.651).The maximum cross-sectional area of PCFP was positively related to the maximum cross-sectional area of IPFP,PFP and QFP,also to the QFP occupancy effect(n=0.314 to 0.368).The signal change grade of PCFP was positively related to the cartilage injuries of knee compartments(medial and lateral patellofemoral joints,the femoral medial and lateral,the tibial medial and lateral)(rs=0.502 to 0.735),and the maximum cross-sectional area of PCFP was related to the lateral femoral cartilage injury(rs=0.305).In addition,the signal change grade of PCFP was positively related to tear of anterior cruciate ligament,BML,medial meniscus tears,lateral meniscus tears,medial meniscus extrusion,exudative synovitis and Park grading(rs=0.425 to 0.789),while the maximum cross-sectional area of PCFP was positively related to BML(rs=0.313).Conclusion MRI signal changes of PCFP could indicate KOA,and the grade of signal changes was correlated with the severity of KOA.

Objective:To explore the effects of knocking down glycine cleavage system H protein (GCSH) on proliferation, apoptosis, oxidative stress and migration of gastric cancer SNU-1 cells in vitro. Methods:SNU-1 cells were cultured in vitro and divided into control group (no transfection) , negative control group (transfection of negative control siRNA) and GCSH knockdown group (transfection of GCSH siRNA) . Quantitative PCR was used to detect the knockdown effect. Immunofluorescence was used to observe the morphology of cells in each group. CCK-8 was used to test the proliferation of SNU-1 cells. Flow cytometry was used to detect the apoptosis and oxidative stress level, and scratch test was used to detect the cell migration. Results:Quantitative PCR experiment showed that the relative expression levels of GCSH in the control group, negative control group and GCSH knockdown group were 1.29±0.16, 1.36±0.17 and 0.32±0.04, respectively ( F=90.32, P<0.001) . There was no significant difference between the control group and negative control group ( P=0.497) . Compared to the negative control group, the GCSH knockdown group was significantly decreased ( P<0.001) . Immunofluorescence experiment showed no significant difference in the morphology of cells among the groups. The CCK-8 experiment results showed that the cell proliferation activities of the control group, negative control group and GCSH knockdown group were 2.63±0.12, 2.61±0.14, 2.45±0.14, respectively ( F=6.35, P=0.005) . There was no significant difference between the control group and negative control group ( P=0.751) , and the GCSH knockdown group significantly decreased compared to the negative control group ( P=0.011) . The results of flow cytometry showed that the early stage apoptosis rates of SNU-1 cells in the control group, negative control group and GCSH knockdown group were (13.38±0.45) %, (12.86±0.65) %, (20.04±3.61) %, respectively ( F=15.37, P<0.001) . There was no significant difference between the control group and negative control group ( P=0.559) . Compared to the negative control group, the GCSH knockdown group significantly increased ( P=0.002) . The late stage apoptosis rates of the three groups were (2.21±0.25) %, (2.68±0.45) %, (5.67±1.67) %, respectively ( F=18.24, P<0.001) . There was no significant difference between the control group and negative control group ( P=0.356) . Compared to the negative control group, the GCSH knockdown group showed a significant increase ( P=0.024) . The reactive oxygen species positive rates in the control group, negative control group and GCSH knockdown group were (26.98±8.79) %, (28.27±5.63) %, (48.41±0.94) %, respectively ( F=22.56, P<0.001) . There was no significant difference between the control group and negative control group ( P=0.950) . Compared to the negative control group, the GCSH knockdown group significantly increased ( P<0.001) . The cell migration rates of the control group, negative control group and GCSH knockdown group were (48.29±5.79) %, (51.66±2.29) %, (14.01±1.56) %, respectively ( F=148.80, P<0.001) . There was no significant difference between the control group and negative control group ( P=0.328) . Compared with the negative control group, the GCSH knockdown group significantly decreased ( P<0.001) . Conclusion:Knock down of GCSH gene can inhibit the proliferation and migration, increase cell apoptosis rate and oxidative stress of SNU-1 cells in vitro. GCSH gene may be a potential target for the treatment of gastric cancer.

Objective:To explore the feasibility of MRI to assist the early diagnosis of midfoot tendon and ligament injuries.Methods:Fifty-two patients with midfoot ligament and tendon injuries who visited Beijing Jishuitan Hospital from September 2016 to December 2021 were enrolled in the study, and 20 healthy volunteers were recruited as controls. All participants underwent mid foot coronal (short axis), sagittal, and axial (long axis) MRI T1 weighted imaging and proton fat suppression sequence examination. The MRI images were evaluated by 2 senior radiologists independently.Results:The consistency of the two radiologists in diagnosis of tendons, ligaments, bones, and soft tissues were good ( κ=0.916, 0.896, and 0.893, respectively). The tendons and ligaments of the midfoot in 20 healthy volunteers (40 feet) showed uniform bands of varying thickness with slightly low signal intensity; the anterior tibial tendon showed a thin line shape, the posterior tibial tendon showed a slightly thick band with uniform low signal intensity, and the calcaneonavicular ligament showed a thin line-like low signal intensity running in different directions. In 52 patients with midfoot tendon and ligament injuries, 18 had anterior tibial tendon injuries, 20 had posterior tibial tendon injuries, and 14 had calcaneonavicular ligament injuries. The injured tendon or ligament was characterized by uneven thickness, blurred edges, and continuous interruption on T1WI sequence, uneven enhancement of signal in the tendon or ligament running area on PD-FS sequence, accumulation of fluid in the tendon sheath, and partial tearing. The partial tear showed discontinuity and thickening of tendons, while the complete tear showed that the tendons were interrupted and retracted, the fiber structure disappeared and was filled with liquid, and the surrounding soft tissue edema was present. Conclusion:MRI can clearly display the course and anatomical structure of the attachment end of the midfoot tendon and ligament, which may assist in early diagnosis of midfoot tendon and ligament injuries.

This article reported the genetic analysis of a case diagnosed with fetal micrognathia and cleft palate by mid-trimester ultrasound in two consecutive pregnancies. In the first pregnancy, the pregnant woman delivered a full-term boy transvaginally, who died two weeks after birth and was diagnosed with Pierre Robin sequence (PRS). Chromosome karyotype and genomic copy number variation. In the second pregnancy, the woman underwent amniocentesis due to suspected PRS presenting by fetal cleft palate, micrognathism, and additional ultrasound anomalies. No abnormalities were detected in fetal karyotype or genomic copy number variation. Whole-exome sequencing, bioinformatics analysis, and Sanger sequencing suggested that both the fetus and the firstborn boy inherited a possible pathogenic variant of c.79delG p.E27Sfs*24 in the BMP2 gene from the mother. The pregnancy was terminated after the genetic consultation. Fetal phenotypes in the two fetuses were similar, indicating that short stature, facial dysmorphism, and skeletal anomalies with or without cardiac anomaly in the pedigree were caused by the heterozygous variant of c.79delG p.E27Sfs*24 in the BMP2 gene.

OBJECTIVE To mine the focus and emotional attitude of the public on rare diseases， and to provide decision- making reference for relevant departments to formulate and implement relevant policies， systems and strategies for medical security of rare diseases. METHODS Latent Dirichlet allocation （LDA） topic model and sentiment analysis method were used to analyze the comment text of short videos related to the “nosinasine” medical insurance admission event on the Bilibili video website， mine the theme and sentiment tendency of the text， and put forward relevant strategy suggestions. RESULTS A total of 8 videos with tens of thousands of playback and 7 109 text data were obtained. According to the LDA analysis， online public paid attention to 9 topics related to rare diseases （the price of rare disease drugs， the inclusion of rare disease drugs in medical insurance， the status quo of research and development of rare disease drugs， the scope of medical insurance and the medical security system， the plight of rare disease patients， the prevention and screening of rare diseases， the value of rare disease drugs in medical insurance， the Chinese and western medical methods of rare diseases， and the supply and demand status of rare disease drugs）， which could be summarized into 4 categories according to the objects of concern （rare disease drugs， rare disease medical insurance， rare disease medical and health services and rare disease patient groups）. On the whole， the emotional tendency of the Internet public towards each topic showed a low positive and high negative tendency. CONCLUSIONS The public paid more attention to the price， research and development， supply and demand of rare disease drugs， and was deeply worried about the current medical status of rare diseases in China. To strengthen and improve the medical security for patients with rare diseases， such as actively carrying out public health services for rare diseases， strengthening cooperation in the diagnosis and treatment of rare diseases， and researching rare disease drugs， etc. Chinese medical and health departments can make concerted efforts in medical and health services， drug supply security， medical security and other social security.

ObjectiveTo explore the features and assessment for far space neglect in left spatial neglect patients after right brain stroke. MethodsFrom January to October, 2021, 30 left unilateral spatial neglect (USN) patients after right stroke (patients, n = 30) from Beijing Bo'ai Hospital and healthy volunteers matching with gender, age and level of education (controls, n = 30) were evaluated with line cancelation (LC), star cancelation (SC) and line bisection (LB) tests, nearly and far away. The 25 controls were evaluated with LB on the second day. ResultsNo line or star was omissed in the controls. Both the deviation and percentage were more in the patients than in the controls (|t| > 4.319, P < 0.001). Both the deviation and percentage were less different for all the test (|Z| < 1.638, t = -1.282, P > 0.05) between nearly and far away, except the deviation of LB (t = -4.994, P < 0.001). The ICC of test-retest was above 0.462 (P < 0.01). ConclusionRight brain stroke patients with USN may present far spatial neglect, which can be assessed with LB.

OBJECTIVE: To assess the value of copy number variations (CNVs) and chromosomal karyotyping analysis for patients with intellectual disability/developmental delay (ID/DD). METHODS: Chromosomal karyotype analysis was applied to 530 children diagnosed with ID/DD. Single nucleotide polymorphism array (SNP-array) was further applied for 120 children with unknown etiology. RESULTS: Among the 530 children with ID/DD, 104 (19.62%) were detected with chromosomal abnormalities. For the 120 children analyzed by SNP-array, 44 (36.67%) were detected with CNVs, among which 20 were predicted as pathogenic, 6 as likely pathogenic, 10 as variants of unknown significance, 7 as likely benign,and 1 as loss of heterozygosity. CONCLUSION SNP-array can facilitate delineation of the etiology of patients with ID/DD, which may provide a basis for their prognosis, consultation and clinical intervention.
Child ; Chromosome Aberrations ; DNA Copy Number Variations ; Developmental Disabilities/genetics* ; Humans ; Intellectual Disability/genetics* ; Karyotyping