Objective:To investigate the correlation between the clinical features and endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) in patients with cirrhosis.Methods:A total of 148 patients with cirrhosis and portal hypertension who underwent EUS-PPG measurement at the Third Xiangya Hospital of Central South University from March 15, 2022 to June 20, 2023 were selected. The clinical data of patients collected before EUS-PPG measurement were analyzed. Variations in the EUS-PPG across different clinical data subgroups were analyzed. Multivariate linear regression analysis was used to explore the independent factors influencing EUS-PPG.Results:The EUS-PPG was significantly elevated in patients exhibiting red signs (16.62±5.33 mmHg VS 13.44±5.34 mmHg, t=3.616, P<0.001), gastroesophageal varices (15.78±5.30 mmHg VS 9.70±4.77 mmHg, t=4.247, P<0.001), hepatic encephalopathy (20.83±7.52 mmHg VS 14.92±5.35 mmHg, t=2.606, P=0.010), thrombocytopenia (15.66±5.39 mmHg VS 13.29±5.83 mmHg, t=2.136, P=0.034), hypoproteinemia (16.13±5.86 mmHg VS 14.12±5.03 mmHg, t=2.230, P=0.027), and an increased international normalized ratio (16.25±6.00 mmHg VS 14.40±5.11 mmHg, t=2.022, P=0.045). Conversely, the EUS-PPG was significantly reduced in patients with a history of splenectomy and devascularization (13.17±5.88 mmHg VS 15.73±5.34 mmHg, t=-2.379, P=0.019). The EUS-PPG in patients with varying degrees of ascites (no VS slight VS moderate or severe: 13.40±5.48 mmHg VS 15.90±5.49 mmHg VS 16.69±5.17 mmHg, F=5.188, P=0.007) and different Child-Pugh classifications (A VS B VS C: 14.07±5.05 mmHg VS 15.69±5.74 mmHg VS 17.64±5.99 mmHg, F=3.066, P=0.049) increased gradually. Multivariable linear regression analysis showed that red signs ( β=2.44, t=2.732, P=0.007), gastroesophageal varices ( β=4.45, t=2.990, P=0.003), ascites ( β=1.75, t=2.368, P=0.019), and hepatic encephalopathy ( β=5.82, t=2.644, P=0.009) were independent factors for the elevated EUS-PPG. Conclusion:There is a significant correlation between EUS-PPG and the clinical features related to the severity of cirrhotic portal hypertension, which indicates the feasibility of EUS-PPG in evaluating cirrhotic portal hypertension.

Objective:To investigate the correlation between serum insulin-like growth factor 1 (IGF-1), thyroid stimulating hormone (TSH), degree of insulin resistance and thyroid nodule imaging reporting and data system (TI-RADS) grading in patients with type 2 diabetes mellitus (T2DM).Methods:The clinical data of 120 patients with T2DM from February 2020 to November 2021 in Kunshan Hospital of Integrated Traditional Chinese and Western Medicine were retrospectively analyzed. Among them, 56 patients had no thyroid nodules (non-thyroid nodule group), all patients were TI-RADS grade 1; 64 patients had thyroid nodules (thyroid nodule group), including 7 cases of TI-RADS grade 2, 12 cases of TI-RADS grade 3, 20 cases of TI-RADS grade 4, and 25 cases of TI-RADS grade 5. The levels of IGF-1 and TSH were measured by automated biochemical analyzer, the homeostatic model assessment insulin resistance index (HOMA-IR) was calculated. Spearman method was used for correlation analysis; multivariate Logistic regression was used to analyze the independent risk factors of TI-RADS grading in patients with T2DM combined with thyroid nodules; the receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of IGF-1, TSH and HOMA-IR in predicting TI-RADS grading in patients with T2DM combined with thyroid nodules.Results:The IGF-1, TSH and HOMA-IR in thyroid nodule group were significantly higher than those in non-thyroid nodule group: (185.35 ± 45.08) ng/L vs. (168.36 ± 30.25) ng/L, (2.98 ± 0.85) mU/L vs. (2.69 ± 0.35) mU/L and 3.25 ± 0.75 vs. 2.95 ± 0.44, and there were statistical differences ( P<0.05 or <0.01). In patients with T2DM combined with thyroid nodules, with the increase of TI-RADS classification, the IGF-1, TSH and HOMA-IR gradually increased, and there were statistical differences ( P<0.05). Spearman correlation analysis result showed that the levels of IGF-1, TSH and HOMA-IR were positive correlation with TI-RADS grading ( r = 0.918, 0.906 and 0.920; P<0.05). Multivariate Logistic regression analysis result showed that the IGF-1, TSH and HOMA-IR were independent risk factors for TI-RADS grading in patients with T2DM combined with thyroid nodule ( OR = 1.684, 1.044 and 1.851; 95% CI 0.674 to 6.665, 0.032 to 0.055 and 1.212 to 2.298; P<0.01 or <0.05). ROC curve analysis result show that the area under the curve of IGF-1, TSH and HOMA-IR for predicting the TI-RADS grading patients with T2DM combined with thyroid nodule were 0.946, 0.983 and 0.975, with all sensitivity of 100.00%, and specificity of 82.14%, 91.07% and 89.29%. Conclusions:There is a correlation between IGF-1, TSH, HOMA-IR and TI-RADS grading in patients with T2DM combined with thyroid nodule, which has some guiding value for clinical monitoring of thyroid nodule changes.

Objective:To retrospectively analyze the classification of twin reversed arterial perfusion(TRAP) by prenatal ultrasound diagnosis, and to explore the clinical significance of this classification method.Methods:One hundred and fourteen TRAP cases were selected for prenatal ultrasound examination from January 2001 to January 2020 in Maternal and Child Health Hospital of Hubei Province, and were studied following the classification: hemiacardius(type Ⅰ), anceps trunk(type Ⅱ), acephalus trunk(type Ⅲ), acephalus acormus(type Ⅳ), acardius amorphous(type Ⅴ). Natural pregnancy outcomes were analyzed between group A(type Ⅰ, type Ⅱ, type Ⅲ) and group B(type Ⅳ, type Ⅴ).Results:Among 114 cases of TRAP, 27 cases (23.7%) were live birth, 33 cases (29.0%) were intrauterine death, 7 cases (6.1%) were perinatal death, 22 cases (19.3%) were induced labor complicated with heart failure, 4 cases (3.5%) were induced labor with malformation of pump twin, 21 cases (18.4%) were induced without heart failure of pump twim. Among 114 cases of TRAP, 20 cases (17.5%) were type Ⅰ, 27 cases (23.7%) were type Ⅱ, 48 cases (42.1%) were type Ⅲ, 8 cases (7.0%) were type Ⅳ and 11 cases (9.7%) were type Ⅴ. The prognosis of group B was better than group A during natural pregnancy ( P=0.007). Conclusions:Based on the diagnosis of prenatal ultrasound, the prognosis of type Ⅳ and type Ⅴ TRAP is better than that of type Ⅰ, type Ⅱ and type Ⅲ. The classification by prenatal ultrasound has positive significance for the clinical prognosis of pump twin.

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.

Objective To explore the characteristics of prenatal ultrasound image of triplet pregnancy complicated by twin reversed arterial perfusion sequence (TRAPS) and improve early diagnosis of this rare fetal malformation. Methods Compare the ultrasound and pathological findings of 6 cases of triplet pregnancy with TRAPS fetus by prenatal ultrasound diagnosis and postnatal diagnosis from April 2001 to April 2017 in Hubei Maternal and Child Health Hospital, and summarize the characteristics of prenatal ultrasound images of TRAPS fetus. Results Sonographic findings of the six triplet pregnancy were as follows: (1) Acardiac fetus: all acardias were absence of heart and beat, with hypogenetic lower limbs, five with skin edema and lymphoedema, five were absence of fetal head while one with stunted head, one with hypogenetic upper limb, four with spin and abdominal cavity, four acardias had single umbilical artery and were supplied by umbilical artery draining towards the fetus, two cases showed no blood flow in umbilical artery and fetal body. (2) Pump fetus: all of the six cases with normal anatomical structure, two showed normal amniotic fluid volume while four showed polyhydramnios, three cases had prenatal cardiac dysfunction (one case survived, two cases of intrauterine demise). (3) The third fetal of the triplets (TRAP co-twin ): during the Prenatal ultrasound follow-up five fetus had normal morphology with normal heart function, one fetal with multiple malformations. Prognosis of the triplet pregnancy: one triplet cesarean delivery two normal boys, five triplets were of poor prognosis (four pump fetus of intrauterine demise, one pump fetal of premature death: one TRAP co-twin of intrauterine demise, two TRAP co-twins of premature death, two TRAP co-twins of induced labor), four acardia twins of intrauterine spontaneous blood blocking, two still birth. Fetal chorionic and amniotic membrane: four cases were dichorionic triamniotic triplet pregnancy, one case was monochorionic triamniotic triplet gestation, one case was monochorionic diamniotic triplet pregnancy. Six cases were confirmed by pathologic anatomy. Conclusion Triplet pregnancy complicated by TRAPS is a rare and severe multiple pregnancy complication, with its characteristic acoustic image characteristics, combined with color doppler, prenatal ultrasound has a high diagnostic value.

Objective To investigate the value of clinical follow-up in prenatal diagnosis of isolated double aortic arch (DAA) . Methods The clinical follow-up materials were retrospectively reviewed in 17 fetuses . Of all the isolated DAA fetuses ,the accuracy rate of prenatal diagnosis was confirmed by CT ,MRI , autopsy or echocardiography ,and pregnant outcomes were summarized . Results A total of 17 fetuses had a sonographic diagnosis of isolated DAA in our centers at a mean gestational age of 23 -32(27 ± 3) weeks , with mother mean age 19 -44 (28 ± 6) years old . One case of DAA type-A was misdiagnosed ,15 cases were delivered with 2 cases occurred respiratory distress or mild dysphagia ,who received surgical treatment , and 13 cases clinical findings were unremarkable at the fellow-up of 24 months ,the silent-rate of clinical symptoms was 86％ . Termination of pregnancy happened in 2 cases ,with 1 (6％ ) had additional ventricular septal defects ,another ( 6％ ) had additional anomalies of congenital high airway obstruction syndrome . In 17 cases of fetuses with isolated DAA ,there were 15 ( 88％ ) cases with dominant right-sided arch ,1 case (6％ ) with dominant left arch ,and 1 case (6％ ) with equal arches in size .Karyotyping prenatal testing was offered to 15 parents with normal results . Conclusions Prenatal ultrasound can accurately diagnose isolated DAA by multiple sections scan ,expanding diagnostic ideas by combination with other medical imaging data to prevent apparent life-threatening event ,or to guide for ex-utero intrapartum treatment . Isolated DAA clinical follow-up results in good outcome .

Objective To explore the relationship between serum soluble human matrix lysine 2 (sST2) with chronic heart failure(CHF) and its clinical value for diagnosis and prognosis of CHF .Methods 60 cases of CHF and 60 cases of non-CHF were selected as the CHF group and control group respectively ,and the CHF group was divided into sST2 low level group and sST2 high level group according to the diagnostic threshold .The ELISA method was used to detect the serum sST 2 level of each group .The CHF group were followed up for 6 months .Then the influence of sST2 on CHF prognosis survival rate was observed .Results There was no statistical difference in age ,gender ,body mass index ,basic disease history ,basic medication situation and blood lipid indexes between the CHF group and control group(P＞0 .05);serum brain natriuretic peptide(BNP) level in the CHF group was obviously higher than that in the control group(P＜0 .01);serum sST2 levels in the CHF group and control group were (55 .08 ± 3 .98)ng/mL and (10 .46 ± 0 .72)ng/mL ,the difference was statistically significant (P＜0 .01) .Serum sST2 was positively correlated with BNP(r=0 .4606 ,P＜0 .01) ,moreover 95% CI was 0 .3066-0 .5911 .When the critical value was 0 .5303 ,the area under curve ,95% CI ,sensitivity ,specificity and likelihood ratio of sST 2 combined BNP detection were 0 .9362 ,0 .8853 -0 .9877 , 85 .00% (73 .43% -92 .90% ) ,98 .33% (91 .06% -99 .96% ) and 50 .00 respectively .The survival curve had statistical difference between the sST2 low level group and sST2 high level group(P=0 .0149) .Conclusion Serum sST2 can be used as a new biomarker for the diagnosis and prognosis of CHF ,and its combined with BNP may have better diagnostic value.

OBJECTIVETo explore the effects of salidroside (sal) on the expressions of Bcl-2, Bax and caspases-3 proteins in cultured rat subventricular zone (SVZ) neural stem cells (NSCs) exposed to hypoxia injury.

METHODSPrimarily cultured SVZ NSCs from adult SD rats were incubated with salidroside (120 and 240 µmol/L) for 24 h prior to exposure to hypoxia. The cell viability was assessed with MTT assay, and the cell apoptosis was analyzed using TUNEL staining and flow cytometry. Western blotting was performed to detect the expressions of Bcl-2, Bax and caspase-3 in the cells.

RESULTSSalidroside pretreatment of the cells for 24 h resulted in an obvious resistance to hypoxia-induced cell apoptosis and decrement of cell viability (P<0.05). Salidroside also antagonized the effect of hypoxia exposure in lowering Bcl-2/Bax ratio apoptosis of rat neural stem cells and decreased the expression of caspases-3 protein (P<0.05).

CONCLUSIONSalidroside can significantly resist hypoxia-induced. The neuroprotective effect of salidroside may be related to the modulation of expressions of apoptosis-related proteins.

Animals ; Caspase 3 ; metabolism ; Cell Hypoxia ; Cells, Cultured ; Flow Cytometry ; Glucosides ; pharmacology ; Neural Stem Cells ; drug effects ; Phenols ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; metabolism

To study the attachment, proliferation and differentiation of neural stem cells (NSCs) on surface modified PHBHHx films and to establish the theory of PHBHHx application in NSCs-based brain tissue engineering. PHBHHx film was fabricated by a solution-casting method, and the morphology of the film was observed under scanning electron microscopy(SEM). The films were treated by NaOH or lipase, then the surface hydrophilic property was characterized using water contact angle measurement. NSCs were isolated from the cerebral cortex of rat embryos on embryonic day 14.5, and cultured on surface treated PHBHHx films. The morphology of NSCs attached on the film was visualized under SEM, and the survival and differentiation of NSCs were observed through immunocytochemical staining. Compared with the untreated PHBHHx films, the water contact angle of NaOH or lipase treated PHBHHx films decreased dramatically, and the number of NSCs attached significantly increased. NSCs survived well on treated PHBHHx films and differentiated into neurons and glial cells. The amelioration of hydrophilic property of PHBHHx film improved its biocompatibility with NSCs. PHBHHx can serve as a novel CNS tissue engineering biomaterial applied for NSCs transplantation, brain repairing and regeneration.
3-Hydroxybutyric Acid ; chemistry ; Animals ; Caproates ; chemistry ; Cell Adhesion ; physiology ; Cell Differentiation ; drug effects ; Cell Proliferation ; Cells, Cultured ; Cerebral Cortex ; cytology ; Coated Materials, Biocompatible ; chemistry ; Embryonic Stem Cells ; cytology ; Female ; Neural Stem Cells ; cytology ; Rats ; Surface Properties ; Tissue Engineering

Objective To investigate the correlation between quantitative parameters with contrastenhanced ultrasound (CEUS) and microvessel density (MVD).Methods Thirty-four placenta of rat model of preeclampsia underwent CEUS examination.The peak intensity time curves on the enhanced images were analyzed quantitatively with computer to get quantitative parameters[the time to peak(TTP), maximal peak intensity(Imax), the area under curve(AUC) and the mean perfusion volume(V)].These parameters were compared with MVD counted with immunohistochemistry and the correlation was statistically studied.Results The TTP in the enhanced images was (14.55 ± 3.45)s, Imax was (20.83 ± 6.15) dB, AUC was (1868.61 ± 25.76)dB, V was (58.01 ± 23.56)dB, and the MVD of placenta of rat model of preeclampsia was (88.98 ± 24.78) in 34 rats.The Imax was correlated positively to MVD (r = 0.885, P = 0.000) ,AUC was correlated positively to MVD (r = 0.677, P = 0.001), V was correlated positively to MVD (r =0.877, P = 0.000).There was no correlation between TTP and MVD in lesions.Conclusions The Imax,AUC and V calculated with CEUS were correlated to MVD, these parameters were valuable index for quantitative evaluation of placental blood perfusion.