Objective To explore the efficacy of using a single branch stent-graft to treat primary intramural hematoma located at the distal arch or descending aorta in Stanford A type aortic intramural hematoma. Methods From July 2020 to November 2022, 10 patients with primary intramural hematoma of Stanford A type aortic intramural hematoma were treated with endovascular repair using a single branch stent-graft in the Department of Cardiovascular Surgery at The University of Hong Kong-Shenzhen Hospital. There were 9 males and 1 female, aged from 32 to 66 years, with a mean age of (47.0±10.4) years. All patients had intramural hematoma involving the ascending aorta and aortic arch, diagnosed as type A intramural hematoma, with the tear located in the descending aorta. Among them, 6 patients were complicated by ulceration of the descending aorta with intramural hematoma, and 4 patients had changes of the descending aortic dissection. All patients underwent endovascular stent repair, with 8 patients undergoing emergency surgery (≤14 days) and 2 patients undergoing subacute surgery (15 days to 3 months). Results There were no neurological complications, paraplegia, stent fracture or displacement, or limb or visceral ischemia during the perioperative period in all patients. One patient had continuous chest pain after surgery, and the stent had a new tear at the proximal end, requiring ascending aorta and partial arch replacement. As of the latest follow-up, all patients had obvious absorption or complete absorption of the intramural hematoma in the ascending aorta and aortic arch compared with before the operation. Conclusion Single branch stent-graft treatment of retrograde ascending aortic intramural hematoma is safe and effective, with good short-term results.

Objective: To investigate the subclinical eating disorders among college students and to analyze associated factors, so as to provide a basis for the prevention and treatment of eating disorders among adolescents. Methods: From November to December 2023, a total of 5 201 college students were selected by stratified random cluster sampling from one undergraduate college and one specialized college in Yangzhou City, Jiangsu Province. Data on general information, subclinical eating disorders, body image perception, depressive symptoms, anxiety symptoms, and mental health literacy were collected using questionnaires. The Chisquare test was used to compare the detection rates of subclinical eating disorders between groups, and binary Logistic regression was employed to analyze associated factors. Results: The detection rate of subclinical eating disorders among college students was 16.0%. Binary Logistic regression analysis showed that the prevalence of subclinical eating disorders among college students was higher in the following categories:being in a relationship (OR=1.22, 95%CI=1.04-1.44), being overweight and obese (OR=2.75, 3.82, 95%CI=2.24-3.38, 2.89-5.06), overestimation of body shape (OR=2.04, 95%CI=1.68-2.49), being in a depressive state (OR=2.53, 95%CI=1.99-3.21), experiencing anxiety (OR=2.63, 95%CI=2.16-3.20), and having substandard mental health literacy (OR=1.37, 95%CI=1.11-1.70). Conversely, low body weight (OR=0.15, 95%CI=0.10-0.22) and underestimation of body shape (OR=0.37, 95%CI=0.27-0.51) were associated with a lower risk (P<0.05). Conclusions The detection rate of subclinical eating disorders among college students is high, and it is associated with relationship status, body mass index classification, body shape perception, depressive and anxiety symptoms, and mental health literacy. Comprehensive interventions should be implemented to improve the subclinical eating disorders and promote the physical and mental health of college students.

OBJECTIVE: To summarize the application experience and clinical effect of radial artery in total arterial coronary revascularization (TAR) in elderly patients. METHODS: Retrospectively analyzed the clinical data of patients who underwent TAR at the University of Hong Kong Shenzhen Hospital from July 1, 2020 to May 30, 2022. Patients were divided into ≥ 65-year-old group and < 65-year-old group according to age. The radial artery blood flow, diameter, intimal integrity and Allen test were evaluated by ultrasound before operation. The distal ends of radial artery were collected for pathological examination during operation. Coronary artery CT angiography (CTA) was examined postoperatively and follow up. The safety and reliability of ultrasonic assessment of radial artery and application of radial artery in elderly patients with TAR were summarized and analyzed. RESULTS: A total of 101 patients received TAR, including 35 cases aged ≥ 65 years old, 66 cases aged < 65 years old; 78 cases used bilateral radial arteries, and 23 cases used unilateral radial arteries. 4 cases of bilateral internal mammary arteries. All the proximal ends of the radial artery were anastomosed to the proximal end of the ascending aorta, 34 cases were performed of "Y" grafts, and 4 cases were sequential anastomoses. There was no in-hospital death and perioperative cardiovascular events. Perioperative cerebral infarction occurred in 3 patients. 1 patients was reoperated for bleeding. Intra-aortic balloon pump (IABP) assistance was used in 21 patients. Poor wound healing occurred in 2 cases and healed well after debridement. Follow-up of 2 to 20 months after discharge showed no internal mammary artery occlusion and 4 radial artery occlusions; no major adverse cardiovascular and cerebrovascular event (MACCE) occurred, and the survival rate was 100%. There was no significant difference in the above perioperative complications and follow-up endpoints between the two age groups. CONCLUSIONS By adjusting the order of bypass anastomosis and optimizing the preoperative evaluation method, radial artery combined with internal mammary artery can obtain better outcome early in TAR, and can be safely and reliably applied to elderly patients.
Aged ; Humans ; Radial Artery/transplantation* ; Coronary Vessels ; Coronary Artery Bypass/methods* ; Retrospective Studies ; Reproducibility of Results ; Treatment Outcome

OBJECTIVES: To explore the role of mitochondrial CYB 15024G>A mutation in the development of essential hypertension. METHODS: Mitochondrial genome sequences of hypertensive patients were obtained from previous studies. Clinical and genetic data of a hypertensive patient with mitochondrial CYB 15024G>A mutation and its pedigree were analyzed. Lymphocytes derived from patient and family members were transformed into immortalized lymphoblastoid cell lines, and the levels of adenosine triphosphate (ATP), mitochondrial membrane potential and intracellular reactive oxygen species (ROS) were detected. RESULTS: The penetrance of this essential hypertension family was 42.9%, and the age of onset was 46-68 years old. Mitochondrial genome sequencing results showed that all maternal members carried a highly conserved mitochondrial CYB 15024G>A mutation. This mutation could affect the free energy of mitochondrial CYB for secondary and tertiary structure and protein folding, thereby changing its structural stability and the structure of the electron transfer function area around the mutation site. Compared with the control, the cell line carrying the mitochondrial CYB 15024G>A mutation showed significantly decreased levels of mitochondrial CYB, ATP and mitochondrial membrane potential, and increased levels of ROS (P<0.01). CONCLUSIONS Mitochondrial CYB 15024G>A mutation may affect the structure of respiratory chain subunits and mitochondrial function, leading to cell dysfunction, which suggests that the mutation may play a synergistic role in essential hypertension.
Humans ; Middle Aged ; Aged ; Reactive Oxygen Species ; Essential Hypertension/genetics* ; Adenosine Triphosphate ; Cell Line ; Mutation

Objective To investigate the anti-inflammatory effect and mechanism of wilforine. Methods Anti-inflammatory activity of wilforine was investigated in LPS-induced RAW264.7 cells. The cytokines production of RAW264.7 cells was analyzed by ELISA assay and the cell viability was assessed by CCK-8 method. The expression of TRAF6, the phosphorylation of IRAK, p38, ERK and JNK, the degradation of inhibitory κBα (IκBα) and the nuclear translocation of NF-κB p65 were further investigated by western blot. Results Triptolide had no significant toxicity to RAW264.7 cells at concentrations of 25, 50 and 100 μmol/L. and could significantly inhibit the contents of cytokines NO, IL-1β, TNF-α and IL-6. Wilforine significantly decreased the expression of TRAF6 and phosphorylation of IRAK, and inhibited the phosphorylation of ERK, p38, and JNK and degradation of IκBα, and reduced the level of nuclear translocation of NF-κB p65. Conclusion The anti-inflammatory activity of wilforine of LPS-induced RAW264.7 cells is probably via TLR4/MyD88/TRAF6 signaling pathway.

Objective:To conduct data mining on hospital accreditation results for inspirations and clues in hospital management.Methods:The Apriori function contained in the arules package of R software was used to extract the association rules. This practice aimed to analyze association rules of the accreditation results of 56 tertiary hospitals which were made based on tertiary hospital accreditation standard(2011)and Detailed Rules from 2017 to 2019; to explore the correlation between the clauses, and analyze the inspirations for hospital management.Results:A total of 6 566 138 and 247 rules were generated for all clauses and core clauses, receptively. The top 10 rules sorted by lift were selected as strong association rules. Among them, the minimum lift of all clauses and core clauses was 1.41 and 1.53, respectively. There was a strong correlation between the establishment of a quality and safety management team in the hospital and the development & implementation of relevant regulations by the hospital. There were strong correlations among emergency service procedure and regulations, patient rights to know, responsibility system by the first one to receive a complaint, medical safety(adverse)event reporting, development & implementation of antimicrobial management system, as well as training for prevention of multi-drug resistance infection measures, and multi-drug resistance infection hospital infection control system.Conclusions:This study suggested that hospital management should highlight the correlation between regulations development and staffing, that between indicator systems and monitoring feedback systems, and that between indicators in different sectors in the medical process. These correlations can be used as management clues and inspirations for hospital management.

Objective:To evaluate the effect of berberine on the volume and weight of, cell proliferation and apoptosis in transplanted cutaneous squamous cell carcinoma (cSCC) in nude mice inoculated with A431 cells, and to explore the possible mechanism underlying the inhibitory effect of berberine on cSCC.Methods:A431 cells were cultured, and A431 cell suspension was subcutaneously injected into the back of 20 nude mice to establish a nude mouse model of transplanted cSCC. On day 15 after inoculation, these tumor-bearing mice were randomly and equally divided into 4 groups: low-, medium- and high-dose berberine groups intraperitoneally injected with 10, 20 and 25 mg/kg berberine solution respectively, and control group intraperitoneally injected with sodium chloride physiological solution. The treatment was performed once a day for 35 consecutive days. The tumor volume was measured before, and on days 7, 14, 21, 28 and 35 after the start of treatment. After the end of the experiment, the nude mice were sacrificed, and the tumors were removed and weighed to calculate the tumor growth inhibition rate. Histopathological examination was performed in these transplanted tumors, immunohistochemical study was conducted to determine the expression of Ki67, TUNNEL staining was conducted to determine the number of apoptotic cells in the transplanted tumor tissues, fluorescence-based quantitative PCR and Western blot analysis were employed to determine the mRNA and protein expression of apoptosis-related proteins Bax, Bcl-2, caspase-3 and Ezrin respectively. One-way analysis of variance was used for comparisons among multiple groups, and Dunnett- t test for comparisons of each berberine group with the control group. Results:Along with the increase in the dose of berberine and treatment duration, the tumor growth curve gradually became flat, the tumor growth was inhibited to different degrees in the berberine groups, and the high-dose berberine showed the strongest inhibitory effect on the tumor growth. The tumor growth inhibition rate was 31.05%, 66.68%, 76.49% in the low-, medium-, and high-dose berberine groups respectively, and the tumor weight was significantly lower in the 3 berberine groups than in the control group ( t = 4.07, 6.33, 7.26, respectively, all P < 0.01) . Along with the increase in the dose of berberine, histopathological examination of the transplanted tumors showed that the extent and area of tumor cell necrosis increased, while immunohistochemical study showed that the number of Ki67-positive cells gradually decreased. Moreover, the number of Ki67-positive cells was significantly lower in the low-, medium- and high-dose berberine groups than in the control group (all P < 0.01) , but the number of apoptotic cells was significantly higher in the berberine groups than in the control group ( P < 0.05 or < 0.01) . The mRNA and protein expression of Bax, Bcl-2, caspase-3 and Ezrin significantly differed among the 4 groups (all P < 0.01) . In addition, the mRNA expression of Bcl-2 was significantly lower in the low-, medium- and high-dose berberine groups than in the control group (all P < 0.01) , and the protein expression of Bcl-2 was significantly lower in the medium- and high-dose berberine groups than in the control group (both P < 0.01) ; Bax mRNA expression in the high-dose berberine group and caspase-3 mRNA expression in the medium- and high-dose berberine groups were significantly higher than the corresponding mRNAs in the control group respectively ( P < 0.05 or < 0.01) , and the protein expression of Bax and caspase-3 was significantly higher in the low-, medium- and high-dose berberine groups than in the control group (all P < 0.01) ; Ezrin mRNA expression was significantly higher in the high-dose berberine group than in the control group ( P < 0.01) , but its protein expression was significantly lower in the low-, medium-, and high-dose berberine groups than in the control group (all P < 0.01) . Conclusion:Berberine can inhibit the proliferation of A431 cells and promote their apoptosis in the transplanted cSCC of the nude mice, and then suppress the growth of transplanted cSCC in the nude mice to a certain extent, which may be related to the upregulation of Bax and caspase-3 and downregulation of Bcl-2 and Ezrin.

Objective To establish an assay method for unbound teicoplanin in plasma by centrifugal ultrafiltration combined with ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Methods Protein was removed from plasma by a Centrifree^® ultrafiltration device. The ultrafiltrate was injected to determine the unbound concentration of teicoplanin. Endeadvorsil^TM C₁₈ column (1.8 μm, 50 mm×2.1 mm) was used with gradient elution of acetonitrile and 0.02 mol/L ammonium acetate solution (containing 0.1% formic acid). The detection was performed on a triple-quadrupole tandem mass spectrometer by multiple reaction monitoring (MRM)mode via electro spray ionization (ESI). Results The calibration curve of unbound teicoplanin in plasma was linear over the range of 0.10 to 8.00 μg/ml (r=0.999). The intra-assay precision and the inter-assay precision of samples didn't exceed 7.00%. The average relative recovery ratio was 97.9%, and the matrix effect factor was 0.97. The samples had good stability after being stored at room temperature for 10 h or at −20 ℃ for 15 days, and freeze-thawed 3 times (RSDs were all within 6.50%). Conclusion This method is convenient, fast, sensitive and accurate. It provided a basis for clinical development of teicoplanin unbound concentration monitoring.

OBJECTIVE To study the relationship of the expression of PLOD2 protein in laryngeal carcinoma and the clinicopathological features of patients. METHODS The expression of PLOD2 in paraffin-embedded specimens of 114 patients with laryngeal carcinoma was detected by immunohistochemistry. The relationship between the expression of PLOD2 and clinicopathological features was analyzed by χ2 t est, s urvival a nalysis b y K aplan-Meier method, and multivariate analysis of Cox proportional hazard model. The fresh frozen specimens of 8 patients randomly selected from the patients were detected by realtime quantitative polymerase chain reaction and Western blotting for the expression of PLOD2 in tumor tissues and adjacent normal tissues. RESULTS PLOD2 protein was associated w ith c linical s tage a nd T s tage(P <0.05). The expression level of PLOD2 protein in laryngeal squamous cell carcinoma was higher than that in adjacent normal tissue(P <0.05). Kaplan-Meier survival analysis showed that low expression of PLOD2 was associated with patient survival rate(χ2=12.484, P <0.001). Multivariate Cox regression analysis showed that PLOD2 protein expression and M stage were independent risk factors for laryngeal cancer growth (P value, both <0.05). CONCLUSION The level of POLD2 protein expression was positively correlated with clinical stage and T stage. PLOD2 protein is an independent risk factor for the growth of laryngeal cancer. The higher the expression of PLOD2 protein, the lower the prognosis of patients. PLOD2 protein expression may play an important role in the growth and prognosis of laryngeal cancer, and may be a new molecular marker for judging the growth and prognosis of laryngeal cancer.

This paper introduced the training system in obstetrics and gynecology(O&G) in the UK and the MRCOG exam organized by the Royal College of Obstetricians and Gynecologists.Comparisons between the O&G specialists training systems of China and UK found that China should better link the resident training and specialists training for a better posteducational medical education system.China should also try to build a China-UK O&G specialist training program to keep pace with the time,for more O&G specialists of international perspectives in China.