[Analysis of clinical features of 380 cases of special portal hypertension-Abernethy malformation].

Objective: To summarize the clinical features of special portal hypertension-Abernethy malformation reported at home and abroad. Methods: The relevant literature on Abernethy malformation published at home and abroad from January 1989 to August 2021 was collected. Patients'clinical features, imaging and laboratory test results, diagnosis, treatment, and prognosis were analyzed. Results: A total of 380 cases were included from 60 and 202 domestic and foreign literatures. Among them, there were 200 cases of type I, with 86 males and 114 females, and the average age was (17.08±19.42) years, while there were 180 cases of type II, with 106 males and 74 females, and the average was (14.85±19.60) years. The most common reason for the first visit of an Abernethy malformation patient's was gastrointestinal system symptoms such as hematemesis and hematochezia caused by portal hypertension (70.56%). Multiple malformations were present in 45.00% of type Ⅰ and 37.80% of type Ⅱ patients. The most prevalent condition was congenital heart disease (62.22%, and 73.53%). Complications related to Abernethy malformation was occurred in 127 and 105 cases with type I and type II, respectively, with liver lesions in 74.02% (94/127) and 39.05% (42/105) and hepatopulmonary syndrome of 33.07% (42/127) and 39.05% (41/105), respectively. The imaging diagnosis of type I and type II Abernethy malformations were mainly based on abdominal computed tomography (59.00%, and 76.11%). Liver pathology was performed in 27.10% of patients. Blood ammonia increased by 89.06% and 87.50%, and AFP increased by 29.63% and 40.00% in laboratory findings. 9.76% (8/82) and 6.92% (9/130) died, while 84.15% (61/82) and 88.46% (115/130) had improved conditions after medical conservative, or surgical treatment. Conclusion: Abernethy malformation is a rare disease in which congenital portal vein development abnormalities lead to significant portal hypertension and portasystemtic shunt. Patients often seek medical treatment for gastrointestinal bleeding and abdominal pain. Type Ⅰ is more common in women, often associated with multiple malformations, and prone to secondary intrahepatic tumors. Liver transplantation is the main treatment method. Type Ⅱ is more prevalent in males, and shunt vessel occlusion is the first treatment choice. Overall, type Ⅱ has a better therapeutic impact than type Ⅰ.

[Changes of brain function and cognitive function after carotid artery stenting].

Objective: To investigate the effect of carotid artery stenting(CAS) on cognitive function and brain function based on changes of a battery of neuropsychological tests and magnetic resonance imaging. Methods: Thirty-three patients were included with 17 in the stent-placement group and 16 in the control group (receiving medical treatment), among whom, the unilateral or bilateral severe internal carotid artery stenosis was confirmed by cerebral vascular angiography in the department of Interventional Radiology and Vascular Surgery of Zhongda Hospital Southeast University from June 2015 to September 2016.Neuropsychological tests and rest-state blood oxygenation level dependent fMRI were performed at the baseline and six months follow-up.The baseline characteristics and follow-up changes were compared in each group. Results: The overall cognitive function of the stent-placement group was statistically significantly improved (P<0.05) compared with control group, mainly in the executive function, memory, attention and other aspects.The value of amplitude of low-frequency fluctuation(ALFF) showed statistically significant increase (P<0.05, Alphasim correction) in left prefrontal cortex (t=5.861 3, P<0.05), the somatosensory association cortex in left superior parietal lobe(t=5.601 2, P<0.05) and bilateral motor cortical area in posterior frontal lobe (t=5.288 5, P<0.05). The ALFF showed statistically significant decrease (P<0.05, Alphasim correction) in left retrosplenial cingulate cortex(t=-5.590 4, P<0.05), left insular cortex (t=-6.340 8, P<0.05), right insular cortex (t=-8.129 9, P<0.05) and left dorsal anterior cingulate cortex (t=-5.584 8, P<0.05). There was no statistically significant difference (P>0.05, Alphasim correction)between baseline and follow-up results in control group.Besides, the ALFF changes of the left insular cortex (r=-0.591, P=0.033) and bilateral motor cortical area (r=-0.659, P=0.014) were negatively correlated with auditory verb learning test (AVLT) score changes.The ALFF change of bilateral motor cortical area was negatively correlated with the AVLT-delay score change (r=-0.588, P=0.034). And the ALFF change on right insular cortex and the frontal assessment battery (FAB) score change was positively correlated (r=0.638, P=0.025). Conclusions: The overall cognitive function of patients with carotid artery stenosis significantly improve after CAS compared with medical treatment.The change of ALFF value in related brain area is also statistically significant.ALFF Change most in area of Default Mode Network may suggest a mechanism of postoperative neurological recovery in patients with carotid artery stenosis.

[Current epidemiology and pathogenesis of non-alcoholic fatty liver disease-associated liver cancer].

Liver cancer is a common malignant tumor. Although the overall incidence and mortality rates of liver cancer has been decreasing in recent years, the incidence of nonalcoholic fatty liver disease (NAFLD)-associated liver cancer tends to increase. The health and social issues brought by NAFLD-associated liver cancer have attracted more and more attention, and its epidemiology, pathogenesis, and diagnosis and treatment await further research. This article summarizes the current epidemiology and pathogenesis of NAFLD-associated liver cancer.

Burden of syphilis infections in Shenzhen, China: a preliminary estimation.

Information on the prevalence and incidence of sexually transmitted infections is important for developing prevention and control strategies and allocating human and financial resources. However, there are no available estimates of such information for many areas in China. In this study, we used the existing data to make a preliminary estimation of syphilis infections in Shenzhen city, in south-eastern China. Data on prevalence rates of syphilis infections among different populations were obtained from the local HIV/sexually transmitted disease second-generation surveillance programme, and the sizes of different populations were estimated based on the most recently available figures. It was estimated that 83,760 (range 77,490-90,020) people are currently infected with syphilis, giving a prevalence of 0.71-0.82% (0.76% on average) in Shenzhen. Around 18% of these syphilis infections occur among men who have sex with men and another 15.8% and 8.7% occur among female sex workers and their clients, respectively. These estimates suggest that a combination of unprotected paid sex and sex between men may be sustaining the epidemic of syphilis in the study area. The preliminary estimates will assist the government in planning and improving its comprehensive intervention programmes for the future control and prevention of syphilis.

Cytomegalovirus infection in pregnancy.

OBJECTIVES: To investigate the effects of intrauterine human cytomegalovirus (HCMV) infection on pregnancy outcomes and infant development. METHODS: The study group consisted of the HCMV-IgM-positive offspring of 75 pregnant women, and a control group of the non-infected offspring of 73 pregnant women. Chorionic villi, amnionic fluid, and umbilical blood were obtained to detect HCMV-late mRNA with a reverse transcriptase-polymerase chain reaction (RT-PCR) assay. The pregnancy outcomes were followed up. For all offspring, neurological development was evaluated with neurosonography, audiologic development with the brainstem auditory evoked potential (BAEP), and psychomotor development with the Beyley Scale of Infant Development (BSID). RESULTS: In the study group the positive rate of late mRNA was 50% in the chorionic villi and 67.65% in the amnionic fluid and the umbilical blood; the incidence of abnormal pregnancy outcomes (abortion, preterm delivery, stillbirth, etc.) was much higher than in the control group (40% vs. 6.57%; chi(2)=24.06; P=0.001); the abnormal rate of neurosonography results at birth and 3 months after birth was higher in the study group than in the control group (P<0.05), as were BAEP values 4 months after birth (chi(2)=8.960; P=0.003). Scores for the Infant Mental Development Index (MDI) were apparently lower than in the control group. When congenitally infected children were tested at the age of 5.5-6.5 years with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), their rate of mental retardation was still found to be approximately 20%. CONCLUSIONS: Intrauterine HCMV infection is closely related to abnormal pregnancy outcomes, infant neurological damage, mental retardation, and hearing loss.

[Clinical pathologic analysis of congenital malformations in 411 perinates: with 80 autopsy materials].

411 cases of malformed babies in 1960-1985 were analyzed, giving an incidence of 6.8%. The clinical data and autopsy materials showed that the order of occurrence of malformation in various systems was: nervous system, face and neck, muscle, bone and digestive system. Autopsy rate was 37.4% in this series. The ratio of malformed male babies to female was 1.3 to 1. 46.5% of the mothers with malformed baby were at age of 25-29 years and 66.2% delivered at 37 to 41 weeks of gestation. 69.3% of mothers with malformed baby had gestational complications 11 times as high as those delivering normal neonate in the same period (P less than 0.01). Of them hydramnion, premature rupture of membranes, oligoamnios, neonatal asphyxia were obviously higher than those pregnancies with normal baby (P less than 0.01). There is mainly discussed the clinical value of autopsy and the preventive measures in decreasing birth of malformed babies.

High-level expression and novel purification strategy of recombinant thanatin analog in Escherichia coli.

Recombinant thanatin analog (TH1) is a cationic 20-amino-acid antibacterial peptide with a conserved cysteine disulfide bond. It exhibits a broad antibacterial spectrum. Different strategies have been developed to produce small antibacterial peptides using recombinant techniques. To date, no efforts to obtain large quantities of active recombinant TH1 have been reported. This study describes the synthesis of TH1 gene, the heterologous fusion expression of the peptide in Escherichia coli, and the bioactive assay of released TH1. By constructing the expression plasmid (pET32a-TH1), high yields of soluble TH1 fusion protein (0.416 g/L) can be obtained in E. coli. Further optimization studies have been carried out to increase the expression of TH1 in different culture conditions, with the final amount of pure TH1 being 13.2 mg/L. The results show that the expression system provides a simple and reliable strategy for generating large quantities of TH1 by soluble fusion expression in E. coli.

Echocardiographic evaluation of the valves and roots of the pulmonary artery and aorta in the developing fetus.

Because of the fluid-filled lungs in the fetus, the ultrasound beam can penetrate to the root of the pulmonary artery perpendicularly. Using M-mode echocardiography, the following dimensions were measured: the pulmonary and aortic valve excursion in 19 fetuses, and the pulmonary and aortic root internal diameter in 70 fetuses, between 18 and 42 weeks, menstrual age. The measured dimensions were then correlated with the biparietal diameter. The correlation coefficients for the measurements ranged from 0.873 to 0.892. Regression analysis showed that the best fit of the data was a linear model from which the 5% and 95% confidence limits were derived for individual predictions of the arterial dimensions. The ratios of the pulmonary/aortic valve excursion and the pulmonary/aortic internal diameter were approximately 1:1. These results are of potential value in the prenatal detection of great arterial valve or root diseases.

The utero-placental circulation, eugenics and the prevention and treatment of high risk pregnancies.

Through systematic experimental and clinical studies, the physiological regulation of utero-placental circulation and the relation of the disturbance in this acirculation to pathogenic mechanisms of high risk pregnancies-Intrauterine Growth Retardation (IUGR) and Pregnancy-induced hypertension (PIH) were explored. The pharmacological effects and mechanism of a Chinese herbal medicine-Qingxintong in improving, the utero-placental circulation and the therapeutic efficacy in treatment of IUGR and PIH, both accompanied by disturbance of utero-placental circulation, were investigated as well.