Survival after minimally invasive radical hysterectomy with protective colpotomy for early-stage cervical cancer: A systematic review and meta-analysis.

Minimally invasive surgery on treatment of early-stage cervical cancer is debatable. Traditional approaches of colpotomy are considered responsible for an inferior oncological outcome. Evidence on whether protective colpotomy could optimize minimally invasive technique and improve prognoses of women with early-stage cervical cancer remains limited. We produced a systematic review and meta-analysis to compare oncological outcomes of the patients treated by minimally invasive radical hysterectomy with protective colpotomy to those treated by open surgery according to existing literature. We explored PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov from inception to December 2022. Inclusion criteria were: (1) randomized controlled trials or observational studies published in English, (2) studies comparing minimally invasive radical hysterectomy with protective colpotomy to abdominal radical hysterectomy in early-stage cervical cancer, and (3) studies comparing survival outcomes. Two reviewers performed the screening, data extraction, and quality assessment independently. A total of 8 retrospective cohort studies with 2020 women were included in the study, 821 of whom were in the minimally invasive surgery group, and 1199 of whom were in the open surgery group. The recurrence-free survival and overall survival in the minimally invasive surgery group were both similar to that in the open surgery group (pooled hazard ratio, 0.88 and 0.78, respectively; 95% confidence interval, 0.56-1.38 and 0.42-1.44, respectively). Minimally invasive radical hysterectomy with protective colpotomy on treatment of early-stage cervical cancer had similar recurrence-free survival and overall survival compared to abdominal radical hysterectomy. Protective colpotomy could be a guaranteed approach to modifying minimally invasive technique.

Diagnosis of tuberculous uveitis by the macrogenome of intraocular fluid: A case report and review of the literature.

BACKGROUND: Tuberculous uveitis caused by tuberculosis infection factors is common, but tuberculous uveitis caused by Mycobacterium tuberculosis found in the intraocular fluid is rare. This report describes the use of intraocular fluid in the diagnosis of tuberculous uveitis in a patient and reviews the relevant literature. CASE SUMMARY: A 24-year-old woman who was 31-wk pregnant visited Hebei Chest Hospital due to intermittent chest pain, fever, and decreased vision for 3 mo. The hydrothorax test suggested "tuberculous pleurisy", and yellow effusion was extracted from the chest tube twice resulting in a total volume of approximately 800 mL. The patient chose to continue the pregnancy without treatment, and was hospitalized again due to high fever. Following 2 mo of anti-tuberculosis treatment, a healthy boy was delivered by cesarean section. Tuberculous uveitis was diagnosed using tuberculosis Xpert, and intraocular infection was detected by second-generation gene sequencing. Following systemic treatment, the patient gradually improved, and the corrected visual acuity of the left eye gradually increased from 0.08 to 1.0. CONCLUSION: The etiology of uveitis is complex, and it is necessary to assess the patient's general condition and apply molecular biology methods to determine the pathogenesis and guide precise treatment, to improve clinicians' awareness and standardize treatment of the disease.

A study on the rapid diagnosis of chronic heart failure by measuring the difference in pulse oxygen saturation before and after arm compression.

BACKGROUND: Clinically, the pulse oxygen saturation of patients with chronic heart failure does not decrease significantly, and the clinical manifestations of labor-related dyspnea are not typical. As such, it is difficult to make a rapid diagnosis. OBJECTIVE: To investigate changes in pulse oxygen saturation in patients with chronic heart failure and examine the relationship between B-type natriuretic peptide (BNP) and normal pulse oxygen saturation. METHODS: A total of 80 hospitalized patients with chronic heart failure and increased BNP were randomly selected as the study group; the family members of 60 patients without dyspnea were randomly selected as the control group. The researchers measured the value of pulse oxygen saturation before and after upper arm compression, calculating the difference and analyzing the correlation between this difference and BNP values. The data were statistically analyzed using the SPSS Statistics 17.0 program. RESULTS: The decrease in pulse oxygen saturation in the study group was greater than in the control group; the decrease in pulse oxygen saturation of patients with chronic heart failure positively correlated with BNP. CONCLUSION: The value of pulse oxygen saturation in patients with chronic heart failure decreased more than in the control group, and this difference positively correlated with BNP. The measurement of pulse oxygen saturation before and after upper arm compression is a simple and effective method for diagnosing and evaluating chronic heart failure.

Changes in group counseling engagement and conflict and growth in emotional cultivation for children and adolescents.

Group climate is an important factor in group counseling and psychotherapy process and outcome research. The current investigation examined group climate changes (from early to late sessions) at the within-group (i.e., group members) and between-group (i.e., group-as-a-whole) levels in predicting changes in group members' emotional cultivation in group counseling. A total of 236 Taiwanese children and adolescents across 41 groups participated in this study. Members' ratings of group climate (i.e., engagement and conflict) were partitioned into within-group and between-group components, and polynomial regression with response surface analysis was used to examine the association between changes in group engagement and conflict (at the member- and group-level) from early to late group sessions on changes in emotional cultivation. Results supported the theoretical hypothesis that when a group-as-a-whole reported increasing engagement from early to late group sessions, relative to other groups (i.e., between-group effect), members of that group experienced greater growth in emotional cultivation. Results also indicated that group members reported greater growth in emotional cultivation when there was consistent and high engagement or consistent and low conflict from early to late group sessions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Multimodal imaging study of lipemia retinalis with diabetic retinopathy: A case report.

BACKGROUND: Lipemia retinalis (LR) is a rare disease related to hypertriglyceridemia. However, the symptoms of hypertriglyceridemia are insidious and difficult to detect without blood tests. The fundus is the only site where blood vessels can be observed directly. Understanding the specific performance of LR in multimodal imaging fundus examinations can help diagnose more patients with abnormal hyperlipidemia. CASE SUMMARY: A 29-year-old woman with type 2 diabetes presented to our clinic complaining of a six-day loss of visual acuity in the left eye. The fundus color images showed typical LR: Arteries and veins were the same pink-white color. Infrared images showed hyperinfrared reflections of the arteries and veins. Optical coherence tomography (OCT) showed numerous high point-like reflections in the retinal section, corresponding to different calibers of blood vessel sections. Medium reflections were seen in the big vessels of the choroid. Fundus fluorescein angiography (FFA) and optical coherence tomography angiography (OCTA) showed no significant changes. Laboratory examination found a total cholesterol level of 13.98 mmol/L, triglyceride 20.55 mmol/L, which confirmed the diagnosis of LR. After treatment to lower blood lipids and control blood glucose, the fundus imaging showed that the blood lipids in the patient had returned to normal. CONCLUSION: LR shows specific changes in fundus color photography, infrared photography, and OCT. FFA and OCTA were not sensitive to LR changes.

[Noradrenaline modulates the spontaneous firing activities of Purkinje cells via α2-adrenergic receptor in mouse cerebellar cortex].

Cerebellar Purkinje cells (PCs) exhibit two types of discharge activities: simple spike (SS) and complex spike (CS). Previous studies found that noradrenaline (NA) can inhibit CS and bidirectionally regulate SS, but the enhancement of NA on SS is overwhelmed by the strong inhibition of excitatory molecular layer interneurons. However, the mechanism underlying the effect of NA on SS discharge frequency is not clear. Therefore, in the present study, we examined the mechanism underlying the increasing effect of NA on SS firing of PC in mouse cerebellar cortex in vivo and in cerebellar slice by cell-attached and whole-cell recording technique and pharmacological methods. GABAA receptor was blocked by 100 µmol/L picrotoxin in the whole process. In vivo results showed that NA significantly reduced the number of spikelets of spontaneous CS and enhanced the discharge frequency of SS, but did not affect the discharge frequency of CS. In vitro experiments showed that NA reduced the number of CS spikelets and after hyperpolarization potential (AHP) induced by electrical stimulation, and increased the discharge frequency of SS. NA also reduced the amplitude of excitatory postsynaptic current (EPSC) of parallel fiber (PF)-PC and significantly increased the paired-pulse ratio (PPR). Application of yohimbine, an antagonist of α2-adrenergic receptor (AR), completely eliminated the enhancing effect of NA on SS. The α2-AR agonist, UK14304, also increased the frequency of SS. The ß-AR blocker, propranolol, did not affect the effects of NA on PC. These results suggest that in the absence of GABAA receptors, NA could attenuate the synaptic transmission of climbing fiber (CF)-PC via activating α2-AR, inhibit CS activity and reduce AHP, thus enhancing the SS discharge frequency of PC. This result suggests that NA neurons of locus coeruleus can finely regulate PC signal output by regulating CF-PC synaptic transmission.

Unpacking leader responsiveness effects of emotional cultivation groups: Using the variance partitioning method.

Theoretically, group leaders can play a significant role in contributing to the effectiveness of group counseling intervention. However, very few studies have examined the group leader's effects on the client-rated group counseling outcomes. We hypothesized that responsive group leaders who were caring, understanding, and respectful could serve as safe havens and secure bases to facilitate their group members' social and emotional cultivation. The current investigation examined the effects of leader responsiveness on group members' social-emotional cultivation (SEC). A total of 307 Taiwanese children and adolescent clients across 53 groups participated in an eight-session emotional cultivation group intervention. There were five time points of data collection (i.e., preintervention, third group session, sixth group session, postintervention, and a 4-week follow-up), and the variance partitioning method was used to partition longitudinal data into within-member, within-group, and between-group variance components. The results of hierarchical linear modeling revealed that the group leader's responsiveness significantly predicted group members' SEC at each of the three levels of analysis: Individual members had greater change in SEC when (a) they perceived higher leader responsiveness in a time period compared to the average rating of leader responsiveness across all time periods, (b) they perceived higher leader responsiveness compared to the average rating of leader responsiveness across all members in the same group, and (c) the group-as-a-whole perceived higher leader responsiveness than the average rating of leader responsiveness across all groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Analysis of Radial Peripapillary Capillary Density in Patients with Bietti Crystalline Dystrophy by Optical Coherence Tomography Angiography.

OBJECTIVE: We wanted to investigate the radial peripapillary capillary (RPC) network in patients with Bietti crystalline dystrophy (BCD). METHODS: We compared RPC densities in the disk and different peripapillary regions, obtained using optical coherence tomography angiography in 22 patients with BCD (37 eyes) and 22 healthy subjects (37 eyes). The BCD group was then divided into Stage 2 and Stage 3 subgroups based on Yuzawa staging, comparing the RPC densities of the two. RESULTS: The disk area RPC density was 38.8% ± 6.3% in the BCD group and 49.2% ± 6.1% in the control group ( P < 0.001), and peripapillary region RPC density was significantly lower in the BCD group than in the control group (49.1% ± 4.7% and 54.1% ± 3.0%, respectively, P < 0.001). There were no significant RPC density differences between the tempo quadrant and inside disk of Stages 2 and 3 subgroups; the other areas showed a significantly lower RPC density in Stage 3 than in Stage 2 BCD. CONCLUSION: The BCD group RPC density was significantly lower than the control group. The reduction of RPC density in the tempo quadrant occurred mainly in the Stage 1 BCD. In contrast, the reduction of RPC density in superior, inferior, and nasal quadrants occurred mainly in Stage 2.

Evaluation of Sensory Quality for Taiwanese Specialty Teas with Cold Infusion Using CATA and Temporal CATA by Taiwanese Consumers.

The market size of varied carbonated teas and bottled ready-to-drink tea products in Taiwan has surpassed that of traditional Taiwan tea with hot infusion. The consumption behavior of Taiwanese consumers for new and varied types of cold infusion tea products has also differed from that of traditional hot infusion ones. More kinds of Taiwan tea with different fermentation levels are gradually being used as raw materials for various cold infusion tea products. Therefore, to study consumers' responses towards cold-brewed tea has become more important for the market of tea in Taiwan. This study recruited Taiwanese consumers to taste seven Taiwanese specialty tea infusions with various degrees of fermentation, and their opinions were gathered by questionnaires composed of check-all-that-apply (CATA), and temporal check-all-that-apply (TCATA) questions and hedonic scales. We found that both CATA and TCATA data agreed that the sensory features of unfermented and lightly semi-fermented tea infusions could be plainly distinguished from the ones of heavily semi-fermented and fully fermented teas based on correspondence analyses. Through CATA and TCATA, the sensory characteristics of the cold-brewed tea of various fermentation degrees could be clearly identified. The first-hand information of cold tea beverages analyzed through this study could be useful for the development of the market in Taiwan. The proper level of bitterness, astringency, fresh tea leaf flavor, and late sweetness were the essential qualities of cold infusions brewed from lightly fermented teas, which could be the best raw materials for production of cold tea beverages to satisfy as many consumers as possible.

Group counseling change process: An adaptive spiral among positive emotions, positive relations, and emotional cultivation/regulation.

Research has provided empirical support for the effectiveness of group psychotherapy. However, we have little understanding of mechanisms that account for the effectiveness. Thus, there is a need for complex theory-driven hypotheses and analytical models to understand the complexities of change in group counseling. We used Fredrickson's broaden-and-build theory as well as Yalom and Leszcz's proposition about adaptive spirals as guiding frameworks. We then examined the process of how positive emotions or positive relations and emotional cultivation (regulation) reciprocally influence one another to create an upward or adaptive spiral toward greater well-being over the course of group interventions. A total of 196 Taiwanese children and adolescent clients across 33 groups participated in an 8-session emotional cultivation/regulation group intervention. The random intercepts cross-lagged panel model (RI-CLPM) was used for the data analyses in Mplus. Overall, our results supported the broaden-and-build theory and its broaden-, build-, and upward-spiral effects, with the exception of positive affect. Specifically, positive emotions (i.e., gratitude and psychological need satisfaction) and positive relations (i.e., teacher-student relationship and perceived social support) predicted future improvements on emotional cultivation (i.e., the broaden effects). Additionally, improved emotional cultivation was a long-lasting characteristic that could be drawn upon at later moments to drive greater positive emotions and relations (i.e., the build effects). Together, the results supported a reciprocal model with positive emotions and relationships being associated with greater future emotional cultivation and subsequently emotional cultivation being associated with greater future positive emotions and relationships (i.e., the upward spiral or adaptive spiral effects). (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mixed matrix membranes containing fluorescent coordination polymers for detecting Cr2O72- with high sensitivity, stability and recyclability.

Three coordination polymers (CPs) were synthesized by using CdII, fluorescent 9,10-di(4-pyridyl)anthracene (dpa), and cyclohexane-1,4-dicarboxylic acid (H2cda), and they are [Cd2(dpa)2(cda)Cl2]n (1), [Cd(dpa)2(cda)]n (2) and [Cd(dpa)(cda)(H2O)]n (3). Both 1 and 2 are fluorescent and contain nonporous layers. 3 is an isomer of 2 and contains a porous diamondoid network. Fluorescent mixed matrix membranes were prepared by dispersing the particles of 1 or 2 within the matrix of polymethyl methacrylate, and showed high sensitivity and selectivity for detecting Cr2O72- in water. Both stability and recyclability of the MMMs were remarkably higher than those of the CP powders.

Three coordination polymers built by quaternary-ammonium-modified isophthalic acid.

Three coordination polymers based on quaternary-ammonium-modified isophthalic acid, namely, catena-poly[[[aqua-µ2-bromido-di-µ3-hydroxido-methanoldinitratotetracopper(II)]-bis{µ4-5-[2-(tripropylazaniumyl)ethoxy]benzene-1,3-dicarboxylato}] nitrate], {[Cu4Br(C19H28NO5)2(NO3)2(OH)2(CH4O)(H2O)]NO3}n, 1, poly[µ3-bromido-µ2-bromido-bromido-µ3-hydroxido-{µ4-5-[2-(tripropylazaniumyl)ethoxy]benzene-1,3-dicarboxylato}tricopper(II)], [Cu3Br3(C19H28NO5)(OH)]n, 2, and poly[bromido{µ3-5-[2-(tripropylazaniumyl)ethoxy]benzene-1,3-dicarboxylato}zinc(II)], [ZnBr(C19H28NO5)]n, 3, were obtained by solvothermal reactions. Coordination polymer (CP) 1 contains tetranuclear Cu4 units, in which the four Cu atoms are linked by two µ3-OH- groups into a Cu4(OH)2 cluster, which are in turn linked by 5-[2-(tripropylazaniumyl)ethoxy]benzene-1,3-dicarboxylate (cpa-) ligands into a chain structure. CP 2 also contains a tetranuclear Cu4(OH)2 cluster and these are linked with CuBr3 units into chains. The chains are then connected by cpa- ligands into a two-dimensional layered structure. CP 3 contains a two-dimensional layer structure built by binuclear Zn2 units and cpa- ligands. The Br- counter-anions of the quaternary ammonium groups all take part in the construction of the polymeric networks.

Age and gender dependence of liver diffusion parameters and the possibility that intravoxel incoherent motion modeling of the perfusion component is constrained by the diffusion component.

The aim of this study was to establish reference values for middle-aged subjects and to investigate the age and gender dependence of liver diffusion MRI parameters. The IVIM type of liver diffusion scan was based on a single-shot spin-echo-type echo-planar sequence using a 1.5 T magnet with 16 b-values. Diffusion-derived vessel density (DDVD)(b0b2) or DDVD(b0b10) was the signal difference between b = 0 and b = 2 (or b = 10) s/mm2 images after removing visible vessels. IVIM analysis was performed with full fitting and segmented fitting, and with a threshold b-value of 60 or 200 s/mm2 , and fitting started from b = 2 s/mm2 . Thirty-one men (age range: 25-71 years) and 26 men (age: 22-69 years) had DDVD and IVIM analysis, respectively, while 37 women (age: 20-71 years) and 36 women (age: 20-71 years) had DDVD and IVIM analysis, respectively. DDVD results showed a significant age-related reduction for women. IVIM results for full fitting showed excellent agreement with those for segmented fitting using a threshold b of 60 s/mm2 , but this was less good for results with a threshold b of 200 s/mm2 . As age increased, female subjects' Dslow measure showed a significant reduction, while their PF and Dfast measures showed a significant increase. For the age group of 40-55 years, DDVD(b0b2), DDVD(b0b10), Dslow , PF and Dfast were 12.26 ± 3.90 au/pixel, 16.95 ± 5.45 au/pixel, 1.072 ± 0.067 (10-3 mm2 /s), 0.141 ± 0.025 and 61.0 ± 14.0 (10-3 mm2 /s) for men, and 13.35 ± 3.6 au/pixel, 17.20 ± 3.62 au/pixel, 1.069 ± 0.074 (10-3 mm2 /s), 0.119 ± 0.014 and 57.1 ± 13.2 (10-3 mm2 /s) for women, respectively. DDVD measure of this study suggest that aging is associated with a reduction in liver perfusion. There is a possibility that a lower Dslow measure is associated with artificially higher PF and Dfast measures, and that IVIM modeling of the perfusion component is constrained by the diffusion component.

LC-MS Quantification of Site-Specific Phosphorylation Degree by Stable-Isotope Dimethyl Labeling Coupled with Phosphatase Dephosphorylation.

Protein phosphorylation is a crucial post-translational modification that plays an important role in the regulation of cellular signaling processes. Site-specific quantitation of phosphorylation levels can help decipher the physiological functions of phosphorylation modifications under diverse physiological statuses. However, quantitative analysis of protein phosphorylation degrees is still a challenging task due to its dynamic nature and the lack of an internal standard simultaneously available for the samples differently prepared for various phosphorylation extents. In this study, stable-isotope dimethyl labeling coupled with phosphatase dephosphorylation (DM + deP) was tried to determine the site-specific degrees of phosphorylation in proteins. Firstly, quantitation accuracy of the (DM + deP) approach was confirmed using synthetic peptides of various simulated phosphorylation degrees. Afterwards, it was applied to evaluate the phosphorylation stoichiometry of milk caseins. The phosphorylation degree of Ser130 on α-S1-casein was also validated by absolute quantification with the corresponding synthetic phosphorylated and nonphosphorylated peptides under a selected reaction monitoring (SRM) mode. Moreover, this (DM + deP) method was used to detect the phosphorylation degree change of Ser82 on the Hsp27 protein of HepG2 cells caused by tert-butyl hydroperoxide (t-BHP) treatment. The results showed that the absolute phosphorylation degree obtained from the (DM + deP) approach was comparable with the relative quantitation resulting from stable-isotope dimethyl labeling coupled with TiO2 enrichment. This study suggested that the (DM + deP) approach is promising for absolute quantification of site-specific degrees of phosphorylation in proteins, and it may provide more convincing information than the relative quantification method.

Three metal-organic framework isomers of different pore sizes for selective CO2 adsorption and isomerization studies.

Metal-organic frameworks (MOFs) or porous coordination polymers (PCPs) with tunable pore sizes, shapes and functionalities have excellent prospects in many applications, such as carbon capture. Molecular sieving can usually enable very high CO2 adsorption selectivity but has rarely been achieved, because it is difficult to precisely control the pore size in the range of 3-4 Å. We report here three MOF isomers built from CdII, terephthalic acid and 3,6-di(pyridin-4-yl)-1,2,4,5-tetrazine with the same stoichiometric ratio, among which 1 and 2 are framework-catenation isomers and 2 and 3 are framework-topological isomers. 1 contains 2-fold interpenetrated networks (topology of pcu) and 1D ultra-micropores and shows highly selective adsorption of CO2 over N2 and CH4, which is mainly ascribed to the molecular sieving effect of the framework. 2 contains a pcu network with 3D interconnected micropores, and 3 contains a kag network with much larger pores of 15 Å. Framework isomerization, in this case, was shown to be a feasible way of tuning the pore size of a MOF for selective CO2 adsorption. The effects of hydrothermal reaction conditions and additives on the structures and the formation of the MOF isomers were also studied.

Diffusion MRI Derived per Area Vessel Density as a Surrogate Biomarker for Detecting Viral Hepatitis B-Induced Liver Fibrosis: A Proof-of-Concept Study.

Liver vessel density can be evaluated by an imaging biomarker diffusion-derived vessel density (DDVD): DDVD/area(b0b2) = Sb0/ROIarea0 - Sb2/ROIarea2, where Sb0 and Sb2 refer to the liver signal when b is 0 or 2 (s/mm2); ROIarea0 and ROIarea2 refer to the region of interest (ROI) on b = 0 or 2 images; and Sb2 may be replaced by Sb15 (b = 15). This concept was validated in this study. Liver diffusion images were acquired at 1.5 T. For a scan-rescan repeatability study of six subjects, b values of 0 and 2 were used. The validation study was composed of 26 healthy volunteers and 19 consecutive suspected chronic viral hepatitis B patients, and diffusion images with b values of 0, 2, 15, 20, 30, 45, 50, 60, 80, 100, 200, 300, 600, and 800 were acquired. Four patients did not have liver fibrosis, and the rest were four stage 1, three stage 2, four stage 3, and one stage 4 patients, respectively. The intraclass correlation coefficient for repeatability was 0.994 for DDVD/area(Sb0Sb2) and 0.978 for DDVD/area(Sb0Sb15). In the validation study, DDVD/area(Sb0Sb2) and area(Sb0Sb15) were 14.80 ± 3.06 and 26.58 ± 3.97 for healthy volunteers, 10.51 ± 1.51 and 20.15 ± 2.21 for stage 1-2 fibrosis patients, and 9.42 ± 0.87 and 19.42 ± 1.89 for stage 3-4 fibrosis patients. For 16 patients where IVIM analysis was performed, a combination of DDVD/area, PF, and Dfast achieved the best differentiation for nonfibrotic livers and fibrotic livers. DDVD/area were weakly correlated with PF or Dfast. Both DDVD/area(Sb0Sb2) and area(Sb0Sb15) are useful imaging biomarkers to separate fibrotic and nonfibrotic livers, with fibrotic livers having lower measurements.

Noradrenaline inhibits complex spikes activity via the presynaptic PKA signaling pathway in mouse cerebellar slices.

Norepinephrine (NA) is an important neurotransmitter of the cerebellum that regulates synaptic transmission, motor regulation and motor learning under certain conditions via adrenergic receptors (ARs). We previously found that NA depressed cerebellar climbing fiber-Purkinje cell (CF-PC) synaptic transmission via α2-ARs in vivo in mice. We here investigated the mechanisms of NA inhibited CF-PC synaptic transmission in acute cerebellar slices using the whole-cell recording technique and pharmacological methods. Bath application of NA (10 µM) depressed CF-PC synaptic transmission, which exhibited a time-dependent decrease in amplitude of excitatory postsynaptic currents (N1), accompanied by an increase in the paired-pulse ratio (PPR). The NA-induced depression of CF-PC synaptic transmission was significantly prevented by inhibition of protein kinase A (PKA) with either H-89 or KT5720. Furthermore, the NA-induced inhibition of CF-PC synaptic transmission was rescued by activation adenylate cyclase (AC), and the AC-induced enhancement of CF-PC synaptic transmission was depressed by NA. Moreover, inhibition of AC with SQ22536, produced a significant depression of CF-PC synaptic transmission and abrogated the NA-induced depression of CF-PC synaptic transmission. However, the NA-induced depression of CF-PC synaptic transmission was not blocked by intracellular inhibition of PKA with a cell impermeable PKA inhibitor, PKI, or by extracellular inhibition of protein kinase C. These results indicate that NA activates presynaptic α2-AR, resulting in a depression of mouse cerebellar CF-PC synaptic transmission through the AC-PKA signaling pathway.

First case of COVID-19 complicated with fulminant myocarditis: a case report and insights.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of pneumonia. Nevertheless, it has not been reported as the cause of acute myocarditis or fulminant myocarditis. CASE PRESENTATION: A 63-year-old male was admitted with pneumonia and cardiac symptoms. He was genetically confirmed as having COVID-19 according to sputum testing on the day of admission. He also had elevated troponin I (Trop I) level (up to 11.37 g/L) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF) on echocardiography. The highest level of interleukin-6 was 272.40 pg/ml. Bedside chest radiographs showed typical ground-glass changes indicative of viral pneumonia. Laboratory test results for viruses that cause myocarditis were all negative. The patient conformed to the diagnostic criteria of the Chinese expert consensus statement for fulminant myocarditis. After receiving antiviral therapy and mechanical life support, Trop I was reduced to 0.10 g/L, and interleukin-6 was reduced to 7.63 pg/mL. Moreover, the LVEF of the patient gradually recovered to 68%. The patient died of aggravation of secondary infection on the 33rd day of hospitalization. CONCLUSION: COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. This is the first report of COVID-19 complicated with fulminant myocarditis. The mechanism of cardiac pathology caused by COVID-19 needs further study.

Impact of iatrogenic biliary injury during laparoscopic cholecystectomy on surgeon's mental distress: a nationwide survey from China.

BACKGROUND: Iatrogenic biliary injury (IBI) following laparoscopic cholecystectomy (LC) is the most serious iatrogenic complications. Little is known whether LC-IBI would lead to surgeon's severe mental distress (SMD). METHODS: A cross-sectional survey in the form of electronic questionnaire was conducted among Chinese general surgeons who have caused LC-IBI. The six collected clinical features relating to mental distress included: 1) feeling burnout, anxiety, or depression, 2) avoiding performing LC, 3) having physical reactions when recalling the incidence, 4) having the urge to quit surgery, 5) taking psychiatric medications, and 6) seeking professional psychological counseling. Univariable and multivariable analyses were performed to identify risk factors of SMD, which was defined as meeting ≥3 of the above-mentioned clinical features. RESULTS: Among 1466 surveyed surgeons, 1236 (84.3%) experienced mental distress following LC-IBI, and nearly half (49.7%, 614/1236) had SMD. Multivariable analyses demonstrated that surgeons from non-university affiliated hospitals (OR:1.873), patients who required multiple repair operations (OR:4.075), patients who required hepaticojejunostomy/partial hepatectomy (OR:1.859), existing lawsuit litigation (OR:10.491), existing violent doctor-patient conflicts (OR:4.995), needing surgeons' personal compensation (OR:2.531), and additional administrative punishment by hospitals (OR:2.324) were independent risk factors of surgeon's SMD. CONCLUSION: Four out of five surgeons experienced mental distress following LC-IBI, and nearly half had SMD. Several independent risk factors of SMD were identified, which could help to make strategies to improve surgeons' mental well-being.

[Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children].

OBJECTIVE: To study the clinical features and chest CT findings of coronavirus disease 2019 (COVID-19) in infants and young children. METHODS: A retrospective analysis was performed for the clinical data and chest CT images of 9 children, aged 0 to 3 years, who were diagnosed with COVID-19 by nucleic acid detection between January 20 and February 10, 2020. RESULTS: All 9 children had an epidemiological history, and family clustering was observed for all infected children. Among the 9 children with COVID-19, 5 had no symptoms, 4 had fever, 2 had cough, and 1 had rhinorrhea. There were only symptoms of the respiratory system. Laboratory examination showed no reductions in leukocyte or lymphocyte count. Among the 9 children, 6 had an increase in lymphocyte count and 2 had an increase in leukocyte count. CT examination showed that among the 9 children, 8 had pulmonary inflammation located below the pleura or near the interlobar fissure and 3 had lesions distributed along the bronchovascular bundles. As for the morphology of the lesions, 6 had nodular lesions and 7 had patchy lesions; ground glass opacity with consolidation was observed in 6 children, among whom 3 had halo sign, and there was no typical paving stone sign. CONCLUSIONS: Infants and young children with COVID-19 tend to have mild clinical symptoms and imaging findings not as typical as those of adults, and therefore, the diagnosis of COVID-19 should be made based on imaging findings along with epidemiological history and nucleic acid detection. Chest CT has guiding significance for the early diagnosis of asymptomatic children.