AIM:One of the important characteristics of the occurrence and development of triple-negative breast cancer(TNBC)is dysregulated cell metabolism.The aim of this study is to investigate the mechanism of pyruvate dehydrogenase E1 subunit alpha 1(PDHA1),a key enzyme component in aerobic glycolysis,affecting the proliferation,metastasis and invasion of TNBC.METHODS:(1)The expression levels of PDHA1 in breast cancer tissues and adja-cent tissues were analyzed by UALCAN database,KM-plotter database,Gene MANIA database and TCGA database.The expression of PDHA1 was compared according to tumor pathological stage,subtype classification and breast cancer bio-markers.The function of PDHA1 in TNBC was explored by gene enrichment analysis.(2)Immunohistochemistry assays were used to detect the expression of PDHA1 in human TNBC tissue and adjacent tissue samples.(3)Stable PDHA1 knockout and PDHA1 rescue TNBC MDA-MB-231 cells were constructed.The proliferation of MDA-MB-231 cells was de-tected by colony formation assay and cell counting assay.The regulatory effect of PDHA1 on the invasion and migration of MDA-MB-231 cells was detected by in vitro scratch assay and Transwell migration assay.RESULTS:Database analysis showed that the group with high PDHA1 expression in breast cancer had shorter survival and worse prognosis.In clinical specimens,the expression of PDHA1 in cancer tissues was higher than that in adjacent normal tissues.Knockout of PDHA1 inhibited the proliferation,metastasis,invasion and epithelial-mesenchymal transition of MDA-MB-231 cells.CONCLUSION:PDHA1 is overexpressed in TNBC,and it promotes cell proliferation and facilitates TNBC metastasis through the epithelial-mesenchymal transition pathway.

Objective To compare the early outcomes of domestic third-generation magnetically levitated left ventricular assist device (LVAD) with or without concomitant mitral valvuloplasty (MVP). Methods The clinical data of 17 end-stage heart failure patients who underwent LVAD implantation combined with preoperative moderate to severe mitral regurgitation in Fuwai Central China Cardiovascular Hospital from May 2018 to March 2023 were retrospectively analyzed. The patients were divided into a LVAD group and a LVAD+MVP group based on whether MVP was performed simultaneously, and early outcomes were compared between the two groups. Results There were 4 patients in the LVAD group, all males, aged (43.5±5.9) years, and 13 patients in the LVAD+MVP group, including 10 males and 3 females, aged (46.8±16.7) years. All the patients were successful in concomitant MVP without mitral reguragitation occurrence. Compared with the LVAD group, the LVAD+MVP group had a lower pulmonary artery systolic pressure and pulmonary artery mean pressure 72 h after operation, but the difference was not statistically different (P>0.05). Pulmonary artery systolic pressure was significantly lower 1 week after operation, as well as pulmonary artery systolic blood pressure and pulmonary artery mean pressure at 1 month after operation (P<0.01). There was no statistically significant difference in blood loss, operation time, cardiopulmonary bypass time, aortic cross-clamping time, mechanical ventilation time, or ICU stay time between the two groups (P>0.05). The differences in 1-month postoperative mortality, acute kidney injury, reoperation, gastrointestinal bleeding, and thrombosis and other complications between the two groups were not statistically significant (P>0.05). Conclusion Concomitant MVP with implantation of domestic third-generation magnetically levitated LVAD is safe and feasible, and concomitant MVP may improve postoperative hemodynamics without significantly increasing perioperative mortality and complication rates.

OBJECTIVE: To explore the genetic basis of a patient with clinically suspected Loeys-Dietz syndrome (LDS). METHODS: A child who had presented at Beijing Anzhen Hospital in September 2018 was selected as the study subject. Clinical data and family history of the patient were collected, along with peripheral blood samples of the proband and his parents. Whole exome sequencing (WES) was carried out through next-generation sequencing. RESULTS: Candidate variants were searched through bioinformatic analysis focusing on genes associated with hereditary aortic aneurysms. Candidate variant was verified by Sanger sequencing. The patient was found to have cardiovascular abnormalities including early-onset aortic dilatation and coarctation, and LDS syndrome was suspected. WES revealed that he has harbored a heterozygous c.1526G>T missense variant of the TGFBR2 gene. The same variant was not found in either parent and was predicted as likely pathogenic (PM1+PM2_Supporting+ PM6+PP3+PP4) based on the guidelines from the American College for Medical Genetics and Genomics (ACMG). CONCLUSION The TGFBR2 c.1526G>T variant probably underlay the LDS in this patient and was unreported previously in China. Above finding has enriched the mutational spectrum of the TGFBR2 gene associated with the LDS and provided a basis for the genetic counseling for the patient.
Child ; Humans ; Male ; China ; Computational Biology ; Family ; Loeys-Dietz Syndrome/genetics* ; Mutation ; Receptor, Transforming Growth Factor-beta Type II/genetics*

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective:To study the therapeutic effect Tetrandrine (TET) on striatal injury caused by microwave radiation and underlying mechanism.Methods:C57BL/6N mice were randomly divided into blank control group (C), radiation control group (R), TET group (TET) and TET combined with radiation group (TET+ R). The mice of radiation group were exposed to 2.856 GHz 8 mW/cm2 microwave on whole-body for 15 min. TET (60 mg/kg) was injected intraperitoneally once a day for 3 consecutive days. The TET structure was verified by ultraviolet spectrophotometry. The open field experiment was used to detect the change of anxiety in mice. Histopathological and ultrastructural changes of the striatum were observed by light microscopy and transmission electron microscopy (TMT). Quantitative real-time PCR (qPCR) was used to detect gene expression changes of voltage-gated calcium channel (VGCC) subtype in the striatum.Results:The open field experiments showed that the time and distance of mice to explore the central region after microwave radiation were significantly lower than that before radiation ( t=4.60, 5.18, P<0.01), and the TET administration significantly improved these changes ( F=1.43, 4.37, P < 0.05). 7 d after microwave radiation, some neuronal nuclei in the striatum of mice contracted and could be stained deeply, which was more obvious in the globus pallidus area. The partial neuronal apoptosis, swelling and cavitation of glial cell mitochondria, blurring of synaptic gaps, and widening of perivascular gaps in the striatum were observed by TMT. The above lesions were significantly rescued after TET administration. But both microwave radiation and TET administration had no significant effect on the gene expressions of striatal VGCC ( P > 0.05). Conclusions:TET has a therapeutic effect on anxiety-like behavior and structural damage of striatum caused by microwave radiation, which is independent of the expression of striatal VGCC genes.

Objective:To explore the experience to reconstruct large nasal defects with combined local flaps after cutaneous tumor excision based on the aesthetic subunit principle.Methods:From May 2007 to May 2019, based on the nasal aesthetic subunit principle, combined local flaps were used to cover the large nasal defects in 21 cases of nasal tumors that were removed. Among 21 cases, there were 11 cases of basal cell carcinoma, 7 cases of squamous cell carcinoma, and 3 cases of pigmented naevus. The locations were dorsum of nose in 8 cases, nasal side in 7 cases, nasal ala in 5 cases, nasal tip in 1 case, and across two nasal subunits in 17 cases. The area of the defect ranged between 1.3 cm × 0.9 cm and 3.6 cm × 3.1 cm. A local combined skin flap was used to repair the skin defect. The secondary defect of donor site was directly sutured.Results:Among 21 cases, 20 cases acquired complete recovery; 1 case had epiderm necrosis over the far end of the flap achieved healing by the first intention. The nasal defect was successfully repaired in all patients, and the all flaps survived. A total of 21 patients were available for follow-up of 1 to 48 months, no tumor recurrence occurred, and the repaired tissues were well matched to the surrounding tissue, good nasal contour was obtained, and the cosmetic results were satisfactory.Conclusions:Based on the nasal aesthetic subunit principle, the combined local flaps can be used to reconstruct the large nasal defects, and the cosmetic results are satisfactory.

Objective To evaluate the efficacy and security of one-stop hybrid cardiac surgery for the treatment of elderly patients with complex heart disease.Methods From November 2013 to March 2014,a total of 5 patients[4 male,age:71-78years] underwent one-stop hybrid approach in the hybrid operating room with chronic obstructive pulmonary disease (COPD) in 3 cases,2 cases of diabetes,3 cases of hypertension,valvular heart disease in 3 cases,PDA in 1 case,4 patients with multivessel coronary disease.Right minimally invasive cardiac surgery(coronary artery bypass grafting or valvular surgery) and percutaneous intervention were performed in an enhanced operative unit.The efficacy and security of one-stop hybrid cardiac surgery were evaluated after the procedure.Results The one-stop hybrid procedure was successful in all patients.Operation time was (125 ± 28) minutes,CPI time was (65 ± 33) minutes,CPB time was (60 ± 23) minutes,Aortic cross clamping time was (42 ± 18) minutes,postoperative mechanical ventilation time was (20.5 ±6.5)hours and ICU monitoring time was (68.9 ± 16.6)hours.Hospitalization time was (9.8 ± 3.7) days.Patients remained free from angina,prosthetic valve dysfunction and patent ductus arteriosus recanalisation(rang 1 to 5 months) follow-up period.Conclusion One-stop hybrid cardiac surgery provides a reasonable,feasible and safe alternative for treating elderly patients with complex heart disease.

BACKGROUNDSporadic fundic gland polyps (FGPs) are common gastric polyps. Some studies reported that FGPs dramatically increased due to proton pump inhibitors (PPIs) use and a decreased prevalence of Helicobacter pylori (H. pylori) infection in Western countries. However, data are still controversial. This study aimed to identify the relationships between these two factors and FGPs in China.

METHODSConsecutive patients with FGPs detected were retrospectively analyzed. Data including patients' age, sex, symptoms, H. pylori infection, history of PPIs use, and the polyps were documented. Each patient was compared with two randomly selected age- and sex-matched controls with similar symptoms in the same period.

RESULTSDuring the period from March 2011 to March 2012, a total of 328 patients were diagnosed as FGPs in 23 047 patients who underwent routine esophagogastroduodenoscopy and 656 patients without FGPs as controls. The mean age was (55.12±12.61) years, and 75.91% were women. The prevalence of H. pylori in patients with FGPs was significantly lower than in those without FGPs (22.30% (64/287) vs. 42.26% (224/530), P < 0.001, OR 0.392, 95% CI 0.283-0.544). Overall, a total of 54 patients with FGPs (54/328, 16.46%) and 136 patients without FGPs (136/656, 20.73%) received PPIs therapy (P = 0.110). According to the different duration of PPIs use, no significant differences of PPIs use were found between the cases and controls among all subgroups. Moreover, the PPIs use was also similar, regardless of age, sex, H. pylori infection, and the number of polyps.

CONCLUSIONSporadic FGPs may not be induced by PPIs therapy but negatively correlate with H. pylori infection in China, which is not the same with the data in Western countries.

Adenomatous Polyps ; epidemiology ; Adult ; Aged ; China ; epidemiology ; Endoscopy, Digestive System ; Female ; Gastric Fundus ; drug effects ; pathology ; Helicobacter Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Proton Pump Inhibitors ; adverse effects ; Retrospective Studies ; Stomach Neoplasms ; epidemiology

It is of great importance to measure the lesion area in scientific research and clinical practice. The present study aims to solve barrel distortion and measure lesion area with the technology of computer visualization. With the ultimate purpose to obtain the precise lesion area, the study, based on the original endoscopy system and digital image processing technology, dealt with the correction of barrel distortion by lens adjustment, calculated the gastric ulcer area with the aid of Qt database and finally developed an image processing software--Endoscope Assistant (EAS). The results showed that the EAS was accurate in vitro. It was employed to measure the gastric ulcer area of 45 patients and the results were compared with the traditional formula method. It could be well concluded that this technology is safe, accurate and economical for measuring gastric ulcer area.
Algorithms ; Gastroscopy ; methods ; Humans ; Image Enhancement ; Image Processing, Computer-Assisted ; methods ; Software ; Stomach Diseases ; diagnosis ; pathology

Objective To explore an accurate,objective and simple method for barrel distortion correction and lesion area measurement by assistance of computer.Methods The software of Panaroma tool was employed to correct barrel distortion of endoscopy and Image J to measure lesion size and manage the relative measurement error.Computed measurement in vitro of lesion area was established,firstly,by identification of correction factor of Panorama tool to minimize measurement error; then by determination of influence of object distance change between the lens and the image.This measurement was used on patients with gastric ulcer for focal area.Results were compared with those of traditional method.Results Number of 0.1was determined to be the correction factor for barrel distortion of endoscopy.Prior to the correction of the barrel distortion,the relative error of measurement gradually increased with the increasing distance between endoscopy and the image.However,different object distances did not exert influence on the relative measurement error when barrel distortion was corrected by Panaroma tool ( P =0.141 ).A total of 50 foci of gastric ulcer were measured,results from combinational treatment of Panorama tool and Image J showed the areas (35.0 ± 5.0) mm2 were significantly larger than those determined by traditional method [ ( 29.1 ± 4.1 ) mm2,P =0.000 ],with a correlation coefficient of 0.988.Conclusion Computed endoscopic lesion measurement is a relatively accurate,objective and simple method to determine the area of gastric lesions.