[Mid-term efficacy evaluation of ABO incompatible living relative kidney transplantation based on protocol biopsy].

Objective: To evaluate the mid-term efficacy of ABO incompatible living donor kidney transplantation (ABOi-KT) based on the results of routine renal biopsy for transplantation. Methods: Retrospective collection of clinical data from 23 pairs of ABOi-KT donors and recipients at the First Affiliated Hospital of Sun Yat-sen University from July 2015 to November 2021. ABOi-KT was performed on recipients after desensitization treatment, and the results of routine kidney transplant biopsy at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery were analyzed. Combined with blood type antibody levels and renal function recovery, the mid-term efficacy of ABOi-KT was evaluated. Results: Among the 23 recipients, there were 19 males and 4 females; age range from 19 to 47 years old [(29.6±6.7) years old], all underwent ABOi-KT successfully after receiving desensitization treatment. The follow-up time was (44.6±22.4) months, of which 22 cases were followed up for more than 1 year. The incidence rates of rejection reactions at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery were 15.0% (3/20), 11.1% (1/9), 7.7% (1/13), 25.0% (3/12), and 12.5% (1/8), respectively. For receptors with rejection reactions, targeted anti-rejection therapy was performed based on clinical symptoms and various indicators. Borderline T cell mediated rejection (TCMR) can be converted to mild tubular inflammation after anti-rejection treatment. The positive rate of complement C4d in peritubular capillaries was 95.0% (19/20) one week after surgery, and the positive rate of complement C4d was 100% at 3 and 12 months after surgery. The cumulative survival rates at 1, 3, 5, and 7 years after surgery were all 100%. The cumulative survival rates at 1, 3, 5, and 7 years after kidney transplantation were 100%, 93.3%, 84.0%, and 84.0%, respectively. Except for 2 recipients who underwent transplantation in 2017 and experienced kidney failure at 30 and 49 months after surgery, all other transplanted kidneys survived. Conclusions: The results of routine renal transplant biopsy show that ABOi-KT has a good mid-term therapeutic effect. The pathological changes of ABOi-KT can be dynamically observed through routine renal transplant biopsy and targeted treatment for rejection reactions can be provided accordingly.

[Repeated stellate ganglion blockade for the treatment of ventricular tachycardia storm in patients with nonischemic cardiomyopathy: a new therapeutic option for patients with malignant arrhythmias].

Objectives: This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade (R-SGB) as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy (NICM). Methods: This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1, 2021 and January 31, 2022. Lidocaine (5 ml, 1%) was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound, once per day for 7 days. Data including clinical characteristics, immediate and long-term outcomes, and procedure related complications were collected. Results: The mean age was (51.5±13.6) years. All patients were male. 5 patients were diagnosed as dilated cardiomyopathy, 2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy. The left ventricular ejection fraction was 37.8%±6.6%. After the treatment of R-SGB, 6 (75%) patients were free of electrical storm. 24 hours Holter monitoring showed significant reduction in ventricular tachycardia (VT) episodes from 43.0 (13.3, 276.3) to 1.0 (0.3, 34.0) on the first day following R-SGB (P<0.05) and 0.5 (0.0, 19.3) after whole R-SGB process (P<0.05). There were no procedure-related major complications. The mean follow-up was (4.8±1.1) months, and the median time of recurrent VT was 2 months. Conclusion: Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.

[Progress in application of deep learning in orthodontic diagnosis and treatment].

In recent years, the application of artificial intelligence technology in the field of orthodontics has gradually increased, and deep learning, as a hot direction, has also been rapidly applied in the detection, evaluation, diagnosis, prediction and effect evaluation. At present, deep learning research has the advantages of high efficiency and accuracy, but it also has limitations such as weak interpretability and insufficient data volume. This paper reviewed the proposal and development of deep learning, the application in orthodontic diagnosis and treatment, as well as the limitations and countermeasures of the popularization, and prospect of the future research.

[Clinical characteristics and long-term follow-up results of radiofrequency ablation for the treatment of ventricular tachycardia in patients with arrhythmogenic left ventricular cardiomyopathy].

Objective: To investigate the acute and long-term outcome of catheter ablation for the treatment of ventricular tachycardia (VT) in patients with arrhythmogenic left ventricular cardiomyopathy (ALVC). Methods: This retrospective, cross-sectional study enrolled ALVC patients undergoing radiofrequency ablation for the treatment of VT at the First Affiliated Hospital of Nanjing Medical University from January 2011 to December 2018 and collected their clinical characteristics and intraoperative electrophysiological examination. Patients were followed up every 6 months after radiofrequency ablation until August 2021. Echocardiographic results and VT recurrence post radiofrequency ablation were analysed. Results: Totally 12 patients were enrolled (mean age: (42±15) years, 11 males(11/12)). The mean of left ventricular end diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) were (51±5)mm and (65±5)%, respectively. Twelve VTs were induced in 10 patients during the electrophysiological study, and the mean tachycardia cycle length was (293±65) ms. Three-dimensional substrate mapping revealed the diseased area at endocardial site in one patient, at epicardial sites in the other 11 patients (involved endocardial sites in 2 cases) with the basal part near the mitral annulus being the predilection for the substrate (10/11). After the catheter ablation at the endocardial and epicardial sites respectively, the complete procedure endpoint was achieved in all patients (VT cannot be induced post ablation). The median follow-up time was 65 (25, 123) months. One patient was lost to follow-up, and the other 11 patients survived without VT. No significant cardiac function deterioration was detected by the echocardiographic examination ((51±5)mm vs. (52±5)mm, P>0.05 for LVDd, (65±5)% vs. (60±6)%, P>0.05 for LVEF) at the end of follow-up. Conclusion: After radiofrequency ablation, the complete procedure endpoint is achieved in ALVC patients, and the catheter ablation provides long-term ventricular tachycardia control during the long-term follow-up.

Prediction of acute myocardial infarction by multi-parameter coronary computed tomography angiography.

AIM: To investigate the performance of multi-parameter coronary computed tomography angiography (CCTA), including stenosis, plaque qualitative-quantitative characteristics, and fractional flow reserve derived from CCTA (FFRct), to predict acute myocardial infarction (AMI) and build a combined model. MATERIALS AND METHODS: Thirty patients with AMI 90 days after CCTA and 120 matched patients without AMI were enrolled retrospectively. Multiple CCTA parameters were analysed and compared. Independent risk factors were obtained through univariate and multivariate regression analyses, after which a multi-parameter model was built. RESULTS: A total of 150 patients were analysed successfully. The multi-parameter CCTA model (area under the curve, 0.944; p<0.001) had a higher predictive value than each single parameter (p<0.001, all). Independent risk factors were intra-plaque dye penetration (IDP; odds ratio [OR], 8.373; p=0.002), lipid plaque volume (LPV; OR, 1.263; p<0.001), and FFRct ≤0.83 (OR, 8.092; p=0.001). CONCLUSION: This one-stop multi-parameter CCTA model, comprising IDP, LPV, and FFRct as independent risk factors, has good performance to predict AMI.

Invasive pulmonary fungal infections in children with severe human adenovirus type 7 pneumonia: A retrospective study.

BACKGROUND: There has been a rapid increase in the number of human adenovirus type 7 (HAdV-7) and invasive pulmonary fungal infections (IPFIs) co-infection. METHODS: In this study, we included patients with confirmed HAdV-7 infection during the period from 2018 to 2019 to explore clinical characteristics of severe HAdV-7 pneumonia combined with IPFIs. RESULTS: Among the 143 patients, 35 cases were co-infected with IPFIs. Others were assigned to the control group (n Z 108). Patients wereprone to be complicated with respiratory failure, heart failure and hemophagocytic syndromein IPFIs group. Thirty-one species of fungi were detected in the IPFIs group, among whichAspergillus was the most common species. Compared to control group, patients had lowerlevels of WBC, CD3þ T lymphocyte counts and CD19þ B lymphocyte counts in IPFIs group. CONCLUSION: Aspergillus is the most common species in IPFIs combined with severe HAdV-7 pneumonia. For children with severe HAdV-7 pneumonia who are younger, have a long course of disease, and have been admitted to the ICU, we should predict the occurrence of IPFIs when there is multi-system dysfunction and the reduction of CD3+ T lymphocyte counts and CD19+ B lymphocyte counts in course of their disease.

[Comparison of trends in congenital heart disease mortality from 1990 to 2017 between China and North America].

Objective: To compare trends in congenital heart disease (CHD) mortality between China and North America from 1990 to 2017. Methods: Using the data from the Global Burden Of Disease (GBD) study 2017, we analyzed the related indicators of CHD mortality in China and North America from 1990 to 2017, including standardized mortality, number of deaths, age distribution of death population and age-specific mortality of CHD in each birth cohort. Age-period-cohort model was used to calculate the annual percent change of age-standardized and age-specific mortality rates of CHD (% per year), period effect-adjusted age-specific mortality rates, and the relative risk of death among CHD population at different time periods (2000－2004 as reference period) and different birth cohorts (1970 as reference cohort). Results: In 2017, the age-standardized mortality rates for CHD in China and North America were 2.63/100 000 and 1.13/100 000 respectively, a decrease of 50.4% and 49.4% compared to 1990. Of all deaths from CHD in China, 76.8% were found in children under 5 years, which was higher than that in North America (51.7%). For population under 40 years, the period effect-adjusted age-specific mortality was higher in China (0.46-167.94 per 100 000 person-years) than in North America (0.68-22.47 per 100 000 person-years); whereas for population over 40 years, mortality was lower in China (0.13-0.34/100 000 person years) than in North America (0.43-0.72/100 000 person-years).From 1990 to 2017, CHD mortality in China decreased by 1.95% per year. The annual decrease of mortality ranged from 1.95% to 3.64% per year in population under 45 years, but the mortality showed increasing trends among those over 50 years. In 2015－2019, the relative risk of death from CHD decreased by 31% in China and 24% in North America. For 2015 birth cohort, the relative risk of death decreased by 84% in China and by 64% in North America. Conclusions: In the past 30 years, the risk of death from CHD in China has significantly decreased, and the survival gap with North America is dramatically narrowed. However, mortality is higher among younger populations in China than in North America, and the mortality in the elders shows increasing trends each year in China.

Myocardial CT perfusion imaging and atherosclerotic plaque characteristics on coronary CT angiography for the identification of myocardial ischaemia.

AIM: To investigate the value of myocardial computed tomography (CT) perfusion imaging (CTP) and atherosclerotic plaque characteristics (APCs) identified on coronary CT angiography (CCTA) for the detection of myocardial ischaemia by using single-photon-emission CT (SPECT) as a reference. MATERIALS AND METHODS: Thirty-six patients (63.9% males) undergoing combined stress dynamic CTP and CCTA were enrolled and analysed. Myocardial blood flow (MBF) from CTP was quantified and compared between normal and abnormal segments. The ability of CTP and APCs to detect ischaemia was compared to that of SPECT. RESULTS: Nineteen patients with 78 segments had perfusion abnormalities on CTP. A significant difference was seen in MBF values between normal (118.51±27.86 ml/100 ml/min) and hypoperfused (79.60±21.35 ml/100 ml/min) segments (t=15.832, p<0.05). The sensitivity and specificity for identifying ischaemia were 90.91% and 94.97%, respectively, on a per-segment basis, resulting in a r value of 0.737 (p<0.05). On a per-vessel basis, the sensitivity and specificity for detecting ischaemia were 86.67% and 84.62%, respectively, for CTP; 93.33% and 58.97%, respectively, for CCTA; and 86.67% and 87.18%, respectively, for CTP combined with CTA, with an area under the receiver-operator characteristic curve (AUC) being 0.87 (p<0.05) and 0.887 (p<0.05) for CTP and its combination with CTA, respectively. On CCTA, 55 vessels with APCs were detected, with an AUC of 0.737 (p<0.05) for APCs combined with CCTA stenosis and 0.802 (p<0.05) for APCs combined with CTP. CONCLUSIONS: Dynamic stress CTP shows good correlation with SPECT for the detection of ischaemia. Additionally, combining APCs with CCTA stenosis has the ability to discriminate ischaemic stenosis.

Spin-charge-lattice coupling in YBaCuFeO5: Optical properties and first-principles calculations.

We combined spectroscopic ellipsometry, Raman scattering spectroscopy, and first-principles calculations to explore the optical properties of YBaCuFeO5 single crystals. Measuring the optical absorption spectrum of YBaCuFeO5 at room temperature revealed a direct optical band gap at approximately 1.41 eV and five bands near 1.69, 2.47, 3.16, 4.26, and 5.54 eV. Based on first-principles calculations, the observed optical excitations were appropriately assigned. Analysis of the temperature dependence of the band gap indicated anomalies in antiferromagnetic phase transition at 455 and 175 K. Additionally, a hardening in the frequency of the Eg phonon mode was observed at 175 K. The value of the spin-phonon coupling constant was 15.7 mRy/Å2. These results suggest a complex nature of spin-charge-lattice interactions in YBaCuFeO5.

Analysis of metabolic profiles of generalized aggressive periodontitis.

BACKGROUND AND OBJECTIVE: The specific pathogenesis of generalized aggressive periodontitis (GAgP) has not yet been clarified, and few studies have focused on the association between GAgP and metabolomics. To elucidate the roles of metabolic profiles in the status of GAgP, this study aimed to identify the differential metabolic profiles between patients with GAgP and healthy controls using an untargeted metabolomic profiling method. MATERIAL AND METHODS: Serum and gingival crevicular fluid samples were collected from healthy controls (n = 20) and patients with GAgP (n = 20) in this cross-sectional study. The relative levels of biomarkers in the samples were measured by gas chromatography-mass spectrometry. Principal components analysis and orthogonal partial least-squares discriminant analysis were used for statistical analysis. Metabolites were analysed qualitatively using the FiehnLib and NIST databases. Full-mouth probing depth and clinical attachment loss were recorded as indexes of periodontal disease. RESULTS: A total of 349 metabolites were qualitatively detected in the gingival crevicular fluid samples, and 200 metabolites were detected in the serum samples. Compared with healthy controls, patients with GAgP showed significant increases in serum urea and allo-inositol levels. In contrast, glutathione, 2,5-dihydroxybenzaldehyde, adipic acid and 2-deoxyguanosine levels were decreased in patients with GAgP. In the gingival crevicular fluid samples, noradrenaline, uridine, α-tocopherol, dehydroascorbic acid, xanthine, galactose, glucose-1-phosphate and ribulose-5-phosphate levels were increased in patients with GAgP, while thymidine, glutathione and ribose-5-phosphate levels were decreased. CONCLUSION: The metabolomics analysis by gas chromatography-mass spectrometry is an effective and minimally non-invasive way to differentiate the metabolites characteristic of patients with GAgP. Both serum and gingival crevicular fluid metabolomics are significantly different between patients with GAgP and healthy controls. These metabolic profiles have great potential in detecting GAgP and helping to understand its underlying mechanisms.

Serological evidence of high Leptospira exposure among indigenous people (Orang Asli) in Peninsular Malaysia using a recombinant antigen-based ELISA.

The lifestyles of the indigenous people (Orang Asli) of Peninsular Malaysia who traditionally live close to the forest, put them at higher risk of exposure to zoonotic diseases. Leptospirosis has recently emerged as one of the most important diseases of public health concern. Here, we aimed to obtain a baseline data on the level of Leptospira exposure among the 107 Orang Asli volunteers using a recombinant antigen-based ELISA, previously shown to have sensitivity of ~90.0% in comparison to the microscopic agglutination test (MAT). Among the Orang Asli volunteers in this study, 60.7% had IgM against Leptospira and 57.9% were antiLeptospira IgG positive. Of these seropositive individuals, 29.9% had both anti-Leptospira IgM and IgG antibodies. Age was found to be a significant predictor for exposure to Leptospira (P < 0.05) with the younger Orang Asli population more likely to be tested positive for antiLeptospira IgM. The finding of high Leptospira exposure among the Orang Asli volunteers could be due to their socio-economic practices and dependency on the forest for their livelihood. The rapid and sensitive recombinant antigen-based ELISA used in the study, could possibly complement MAT for the epidemiological surveillance of leptospirosis, especially among the underserved populations.

[Efficacy and safety of specific sublingual immunotherapy in children with allergic asthma and rhinitis].

Objective:To evaluate the efficacy and safety of specific sublingual immunotherapy (SLIT) with Dermatophagoides farina drops in different courses with allergic asthma and allergic rhinitis.Method:This study retrospectively analyzed the efficacy of SLIT in 158 children with allergic asthma and rhinitis which induced by house dust mites. The children were treated with Dermatophagoides farina drops; clinical observation and follow-up study were conducted. According to the treatment duration, children were divided into 4 groups (1-year, 2-year, 3-year, and 4-year). Symptom scores and medication scores were recorded at each visit. Asthma symptom scores (day and night), the rhinitis symptom scoresand medication scores were evaluated in 4 groups before and after SLIT. The adverse events during the treatment were collected.Result:There were significant differences in asthma symptom scores (day, night), asthma medication scores, rhinitis symptom scores, rhinitis medication scores among children who accepted 1-year, 2-year, 3-year and 4-year SLI treatment as compared with baseline (P< 0.01). As compared with 1-year, 2-year, 3-year groups, the asthma medication scores of 4-year group had obviously decrease (P< 0.05). Rhinitis medication score of SLIT3 years group was significantly lower than 2 years group (P< 0.05). Asthma symptom scores in the day, asthma symptom scores at night, rhinitis symptom scores of four groups children had no statistically significant difference (P>0.05).Conclusion:Different courses of sublingual immunotherapy with Dermatophagoides farina drops had significant effects; the 4-year course of treatment showed the best effect.

A novel Al matrix composite reinforced by nano-AlNp network.

In pursuit of lightweighting of automobiles and low emission of transportation, the efforts to develop high-strength, heat-resistant and fatigue-resistant Al alloys and/or composites have been ongoing. Here we report a novel Al matrix composite with ultrahigh strength reinforced by a three dimensional network of nano-AlN particles for the first time. The in-situ synthesized AlN particles are connected by twinning bonding chains and built up a three dimensional network strengthening Al matrix enormously like the skeleton to human body. The composite containing 16.4wt.% AlN particles shows excellent properties: the ultimate tensile strengths can be up to 518MPa at room temperature and 190MPa at 350 °C. This peculiar performance results from the novel spatial distribution of nano-scale AlN particles. Our findings in this work would help to develop a potential candidate for high-performance heat resistance light-metal based materials.

A posteromedial approach for open reduction and internal fixation of posteromedial tibial plateau fracture.

The aim of this study was to evaluate the clinical outcomes of patients with posteromedial tibial plateau fractures treated by open reduction and internal fixation (ORIF) through a posteromedial approach. Thirty-six patients with posteromedial tibial plateau fracture underwent ORIF through a posteromedial approach and were retrospectively analyzed. Pre-operative X-ray pictures and CT images were -obtained. And there were 11 cases of posteromedial tibial plateau fracture and 25 cases of posteromedial and posterolateral tibial plateau fracture. All the -patients were treated surgically with posteromedial approach. The clinical outcomes were assessed -according to the Rasmussen knee function grading system. The patients were followed-up for an average of 17.5 months (range, 12-32 months). All the fractures attained satisfactory reduction. No major complications were observed. According to the Rasmussen knee function grading system, the results were graded as excellent in 21 cases, good in 13 cases, fair in 2 cases. The rate of excellent and good results was 94.4%. The posteromedial approach in our opinion is the best option to treat the posteromedial tibial plateau fractures because it can provide direct visualization of the fracture site and avoid dissection of neurovascular bundle in the popliteal fossa area with minimal soft tissue injury.

High-dose glucocorticoids increases the expression of mineralocorticoid receptor in vascular endothelial cells.

OBJECTIVE: To explore the role of glucocorticoid new mechanism to observe the expression of glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) with lipopolysaccharide (LPS) and dexamethasone (Dex) in human umbilical vein endothelial cells (HUVEC). MATERIALS AND METHODS: LPS "injured" endothelial cells with Dex for "treatment", and then detected the expression of glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) in the endothelial cells by RT-PCR and immunohistochemistry. RESULTS: With high dose (10-6 mol/L) of Dex to stimulate cell 3h, GRmRNA no significant changes in the expression, 6h began to decrease, 12h peak, 24h recovered nearly the level before stimulation. Using different concentrations of Dex and 100 ng/ml LPS stimulation, HUVEC MRmRNA expression was decreased, and high dose (10-6 mol/L) of Dex to stimulate cell 3h, MRmRNA no significant changes in expression, and GRmRNA The difference is that the expression began to increase 6h, 12h, peaked, 24h rebound near the level before stimulation. Immunohistochemistry results consistent with the RT-PCR. CONCLUSIONS: Large dose of DEX (10-6 mol/l) up-regulated the expression of MR and GR in the reduction of the contrast exactly. GC induced the expression of GR and MR in different changes of stress injury of the body may be a regulatory mechanism, and indicate one new mechanism of glucocorticoid exist.