Seeing Beyond the Surface: Superior performance of Ultrasound elastography over Milan ultrasound criteria in distinguishing fibrosis of ulcerative colitis.

BACKGROUND: Colonic fibrosis has important clinical implications in ulcerative colitis. Ultrasound imaging has emerged as a convenient and reliable tool in diagnosis of inflammatory bowel disease. We aimed to explore the potential use of ultrasound to evaluate UC fibrosis. METHODS: Consecutive UC patients who had proctocolectomy from July 2022 to Sep 2023 were enrolled in the study. Patients underwent bowel ultrasound examination and ultrasound elastography imaging prior to surgery. Milan ultrasound criteria (MUC) was calculated and bowel wall stiffness was determined using two mean strain ratios (MSRs). Degree of colonic fibrosis and inflammation was measured upon histological analysis. ROC analysis was used to evaluate the performance of ultrasound-derived parameters to predict fibrosis. RESULTS: Fifty-six patients were enrolled with 112 segments included in analysis. The median fibrosis score was 2 (0-4) and the median Geboes score was 5 (0-13) and these two scores were significantly correlated (p<0.001). The muscularis mucosa thickness was significantly higher in moderate-severe fibrosis than none-mild fibrosis (p=0.003) but bowel wall thickness was not (p=0.082). The strain ratios (p<0.001) and MUC (p=0.010) was significantly higher in involved than non-involved segments. The strain ratios were correlated with fibrosis score (p<0.001) but not MUC (p=0.387). At ROC analysis, MSR1 had an AUC of 0.828 (cutoff value 3.07, 95% CI 0.746-0.893, p<0.001) to predict moderate-severe fibrosis. CONCLUSION: Ultrasound elastography imaging could predict the degree of colonic fibrosis in UC. Application of this technique could help disease monitoring and decision-making of UC patients.

Recurrent renal secondary hyperparathyroidism caused by supernumerary mediastinal parathyroid gland and parathyromatosis: A case report.

Background: Surgical parathyroidectomy (PTX) is necessary for patients with severe and progressive secondary hyperparathyroidism (SHPT) refractory to medical treatment. Recurrence of SHPT after PTX is a serious clinical problem. Both supernumerary mediastinal parathyroid gland and parathyromatosis are the rare causes of recurrent renal SHPT. We report a rare case of recurrent renal SHPT due to supernumerary mediastinal parathyroid gland and parathyromatosis. Case presentation: A 53-year-old man underwent total parathyroidectomy with autotransplantation due to the drug-refractory SHPT 17 years ago. In the last 11 months, the patient experienced symptoms including bone pain and skin itch, and the serum intact parathyroid hormone (iPTH) level elevated to 1,587 pg/ml. Ultrasound detected two hypoechoic lesions located at the dorsal area of right lobe of the thyroid gland, and both lesions presented as characteristics of hyperparathyroidism in contrast-enhanced ultrasound. 99mTc-MIBI/SPECT detected a nodule in the mediastinum. A reoperation involved a cervicotomy for excising parathyromatosis lesions and the surrounding tissue and a thoracoscopic surgery for resecting a mediastinal parathyroid gland. According to a histological examination, two lesions behind the right thyroid lobe and one lesion in the central region had been defined as parathyromatosis. A nodule in the mediastinum was consistent with hyperplastic parathyroid. The patient remained well for 10 months with alleviated symptoms and stabilized iPTH levels in the range of 123-201 pg/ml. Conclusion: Although rare, recurrent SHPT may be caused by a coexistence of both supernumerary parathyroid glands and parathyromatosis, which should receive more attention. The combination of imaging modalities is important for reoperative locations of parathyroid lesions. To successfully treat parathyromatosis, all the lesions and the surrounding tissue must be excised. Thoracoscopic surgery is a reliable and safe approach for the resection of ectopic mediastinal parathyroid glands.

Clinical Application of C-TIRADS Category and Contrast-Enhanced Ultrasound in Differential Diagnosis of Solid Thyroid Nodules Measuring ≥1 cm.

BACKGROUND The aim of this study was to investigate the performance of Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) category combined with contrast-enhanced ultrasound (CEUS) in diagnosing thyroid cancer. MATERIAL AND METHODS From October 2020 to March 2021, 116 thyroid nodules from 113 patients who underwent conventional ultrasound and CEUS examinations at the General Hospital of Northern Theater Command were reviewed. In the conventional ultrasound examination, thyroid nodules were categorized by C-TIRADS. The nodules were reclassified based on CEUS scoring, then a combined diagnosis was made. The pathological results were taken as the criterion standard. To compare the diagnostic performance of the 3 methods according to the receiver operating characteristic curves produced for thyroid nodules. RESULTS After chi-square test, the 7 characteristics of enhancement patterns, internal homogeneity, wash-in, wash-out, ring enhancement, morphology, and contrast agent retention characteristics (CAR) were statistically different between malignant and benign tumors; A high diagnostic performance was demonstrated by C-TIRADS combined with CEUS in diagnosing thyroid cancer. The area under the curve (AUC), the sensitivity, and the specificity of C-TIRADS combined with CEUS for diagnosing thyroid cancer were 0.918 (95% CI: 0.852-0.961), 80.9% (95% CI: 69.1-89.8%), and 90.6% (95% CI: 79.3-96.9%), respectively. The AUC of C-TIRADS alone was significantly lower than that of C-TIRADS combined with CEUS (P=0.0056), while there was no significant difference between CEUS and C-TIRADS combined with CEUS (P=0.59). CONCLUSIONS The combined method of C-TIRADS and CEUS, with reduced rate of thyroid nodule biopsy and clinical application value, has higher diagnostic accuracy than the single diagnosis method.

TaMYB29: A Novel R2R3-MYB Transcription Factor Involved in Wheat Defense Against Stripe Rust.

Members of the R2R3-MYB transcription factor superfamily have been implicated in plant development, improved disease resistance, and defense responses to several types of stresses. To study the function of TaMYB29 transcription factor-a member of the R2R3-MYB superfamily-in response to an avirulent race of stripe rust pathogen, Puccinia striiformis f. sp. tritici (Pst), we identified and cloned the TaMYB29 gene from wheat cultivar (cv.) AvS+Yr10 following infection with Pst. The TaMYB29 protein, comprising 261 amino acids, contains two highly conserved MYB domains. We first showed that TaMYB29 is a transcription factor, whose transcriptional levels are significantly induced by salicylic acid (SA), abscisic acid (ABA), jasmonic acid (JA), ethylene (ET), and Pst. The results showed that TaMYB29 is involved in the wheat response to stipe rust. The overexpression of the TaMYB29 gene resulted in the accumulation of reactive oxygen species (ROS) and pathogen-independent cell death in Nicotiana benthamiana leaves. The silencing of TaMYB29 gene in wheat cv. AvS+Yr10, containing the stripe rust resistance gene Yr10, promoted hyphae growth, significantly downregulated the expression of pathogenesis-related (PR) genes, and substantially reduced the wheat resistance to Pst compared with the non-silenced control. In addition, the accumulation of hydrogen peroxide (H2O2) significantly decreased, and the activity of catalase, an enzyme required for H2O2 scavenging, was elevated. Altogether, TaMYB29 positively regulates the defense response against stripe rust in wheat AvS+Yr10 by enhancing H2O2 accumulation, PR gene expression, and SA signaling pathway-induced cell death. These results provide new insights into the contribution of TaMYB29 to the defense response against rust pathogens in wheat.

Painful Diabetic Peripheral Neuropathy Study of Chinese Outpatients (PDNSCOPE): A Multicentre Cross-Sectional Registry Study of Clinical Characteristics and Treatment in Mainland China.

INTRODUCTION: This aim of this study was to delineate current clinical scenarios of painful diabetic peripheral neuropathy (PDN) and associated anxiety and depression among patients in Mainland China, and to report current therapy and clinical practices. METHODS: A total of 1547 participants were enrolled in the study between 14 June 2018 and 11 November 2019. Recruitment was conducted using a multilevel sampling method. Participants' demographics, medical histories, glucose parameters, Douleur Neuropathique 4 Questionnaire (DN4) scores, visual analogue scale (VAS) pain scores, Patient Health Questionnaire 9 (PHQ-9) scores, Generalised Anxiety Disorder 7 (GAD-7) scores and therapies were recorded. RESULTS: The male-to-female ratio was 1.09:1 (807:740), and the mean age at onset was 61.28 ± 11.23 years. The mean DN4 score (± standard deviation) was 4.91 ± 1.88. The frequencies of DN4 sub-item phenotypes were: numbness, 81%; tingling, 68.71%; pins and needles, 62.90%; burning, 53.59%; hypoaesthesia to touch, 50.16%; electronic shocks, 43.31%; hypoaesthesia to pinprick, 37.94%; brushing, 37.82%; painful cold, 29.61%; and itching, 25.86%. Age, diabetic duration, depression history, PHQ-9 score and GAD-7 score were identified as risk factors for VAS pain score. Peripheral artery disease (PAD) was a protective factor for VAS pain score. For all participants currently diagnosed with PDN and for those previously diagnosed PDN, fasting blood glucose (FBG) was a risk factor for VAS; there was no association between FBG and VAS pain score for PDN diagnosed within 3 months prior to recruitment. Utilisation rate of opium therapies among enrolled participants was 0.71% , contradiction of first-line guideline recommendation for pain relief accounted for 9.43% (33/350) and contradiction of second-line guideline recommendation for opium dosage form was 0.57% (2/350). CONCLUSION: Moderate to severe neuropathic pain in PDN was identified in 73.11% of participants. Age, diabetic duration, depression history, PHQ-9 score, GAD-7 score and FBG were risk factors for VAS pain scores. PAD was protective factor. The majority of pain relief therapies prescribed were in accordance with guidelines. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03520608, retrospectively registered, 2018-05-11.

Contrast agent retention features in contrast-enhanced ultrasound: diagnostic performance for the prediction of papillary thyroid carcinoma.

PURPOSE: To report a new feature of contrast-enhanced ultrasound (CEUS) and its diagnostic performance for the prediction of papillary thyroid carcinoma (PTC). METHODS: This retrospective study was conducted from October 2018 to March 2019, including 276 patients with 308 thyroid nodules who underwent CEUS examinations prior to surgery (90 patients, 122 nodules) or fine needle aspiration (186 patients, 186 nodules). Quantitative analysis of CEUS features was performed using time-intensity curves. After surgery, tissue sections stained with HE and an anti-CD34 primary antibody were used to characterize the cell number and microvessel density. The nodules were divided into retention and non-retention groups. RESULTS: There were 168 malignant nodules and 140 benign nodules. The contrast-agent retention (CAR) feature was only observed in 52 papillary carcinomas. The CAR feature showed the sensitivity of 30.9% albeit the high specificity of 100%, for the diagnosis of thyroid cancers. The maximum slope coefficient of the washout index was significantly lower in the retention group than in the non-retention group (P < 0.001). The enhancement intensity during the late stage of enhancement index was significantly higher in the retention group than in the non-retention group (P < 0.001). The cell number and microvessel density in nodules with CAR features were higher (P < 0.001, P = 0.004). CONCLUSION: The combination of the retention pattern of the CEUS observed herein with other CEUS features may be a useful tool to improve the diagnostic of the PTC.

Diagnosis of thyroid cancer using a TI-RADS-based computer-aided diagnosis system: a multicenter retrospective study.

OBJECTIVE: The purpose of this study was to use a computer-aided diagnosis (CAD) system based on the Thyroid Imaging, Reporting, and Data System (TI-RADS) to improve the diagnostic performance of thyroid cancer by analyzing clinical ultrasound imaging data. METHODS: A retrospective diagnostic study of ultrasound image sets was conducted at five hospitals in China. A CAD system based on TI-RADS was applied in this study, and the diagnostic performance of CAD system was tested through multi-center data. The performance of the CAD system was compared with the consensus of three experienced radiologists. The interobserver agreement for cancer diagnosis was calculated between the CAD system and the consensus of the three experienced radiologists. RESULTS: The CAD system performed well in the diagnosis of thyroid cancer, with an area under the curve (AUC) value of 0.902 (95% CI: 0.884-0.918), and obtained results similar to those of the three experienced radiologists. The CAD system performed better in the internal test set than in the external test set (AUC: 0.930 vs 0.877, respectively). The performance of the CAD system in the diagnosis of thyroid cancer for nodules of different sizes (<1 cm, 1-2 cm and ≥2 cm) was basically similar (accuracy: 84.6% vs 85% vs 84.2%). The CAD system can recognize 15 ultrasound features of thyroid nodules, most of which reached the level of 3 experienced radiologists (12/15, 85%). CONCLUSION: The CAD system achieved an improved AUC and similar sensitivity and specificity in the diagnosis of thyroid cancer compared with the consensus of experienced radiologists.

Ultrasound Computer-Aided Diagnosis (CAD) Based on the Thyroid Imaging Reporting and Data System (TI-RADS) to Distinguish Benign from Malignant Thyroid Nodules and the Diagnostic Performance of Radiologists with Different Diagnostic Experience.

BACKGROUND The diagnosis of thyroid cancer and distinguishing benign from malignant thyroid nodules by junior radiologists can be challenging. This study aimed to develop a computer-aided diagnosis (CAD) system based on the Thyroid Imaging Reporting and Data System (TI-RADS) to distinguish benign from malignant thyroid nodules by analyzing ultrasound images to improve the diagnostic performance of junior radiologists. MATERIAL AND METHODS A modified TI-RADS based on a convolutional neural network (CNN) was used to develop the CAD system. This retrospective study reviewed 789 thyroid nodules from 695 patients and included radiologists with different diagnostic experience. Five study groups included the CAD group, the junior radiologist group, the intermediate-level radiologist group, the senior radiologist group, and the group in which the junior radiologist used the CAD system. The ultrasound findings were reviewed and compared with the histopathology diagnosis. RESULTS The CAD system for the diagnosis of thyroid cancer showed an accuracy of 80.35%, a sensitivity of 80.64%, a specificity of 80.13%, a positive predictive value (PPV) of 76.02%, a negative predictive value (NPV) of 84.12%, and an area under the receiver operating characteristic (ROC) curve (AUC) of 0.87. The accuracy of the junior radiologists in diagnosing thyroid cancer using CAD was similar to that of intermediate-level radiologists (79.21% vs. 77.57%; P=0.427). CONCLUSIONS The use of ultrasound CAD based on the TI-RADS showed potential for distinguishing between benign and malignant thyroid nodules and improved the diagnostic performance of junior radiologists.

Noninvasive inflammatory markers for assessing liver fibrosis stage in autoimmune hepatitis patients.

OBJECTIVE: To examine the accuracy of noninvasive inflammatory markers in predicting liver fibrosis stage in patients with autoimmune hepatitis (AIH). PATIENTS AND METHODS: We enrolled 55 patients with AIH and 60 healthy controls in this study, and divided them into three groups: F0 (control); F1-F3 (noncirrhotic fibrosis); and F4 (cirrhosis). The following markers were analyzed for all participants: lymphocyte-to-neutrophil ratio (LNR); lymphocyte-to-platelet ratio (LPR); lymphocyte-to-monocyte ratio (LMR); immunoglobulin-to-platelet ratio (IGPR); aminotransferase-to-platelet ratio index (APRI); aspartate aminotransferase-to-alanine aminotransferase ratio (AAR); and fibrosis-4 score (FIB-4). The predictive accuracy of these noninvasive markers was assessed using area under the receiver operating characteristic curve. Multivariate ordinal logistic regression models were used to analyze associations between the noninvasive markers and liver fibrosis stage. RESULTS: AAR, LPR, LMR, IGPR, APRI, and FIB-4 were linked to liver fibrosis-stage (P < 0.05), with correlation indices of - 0.219, 0.258, - 0.149, 0.647, 0.841, and 0.704, respectively, but not LNR (P = 0.093). area under the receiver operating characteristic curves of LPR, IGPR, AAR, LMR, APRI, and FIB-4 for detecting cirrhosis (F4 vs. F0-F3) were 0.936 (95% confidence interval: 0.870-1.000, P < 0.001), 0.939 (0.875-1.000, P < 0.001), 0.528 (0.319-0.738, P = 0.768), 0.555 (0.409-0.700, P = 0.568), 0.798 (0.694-0.902, P = 0.002), and 0.881 (0.796-0.967, P < 0.001). Our multivariate ordinal regression analysis showed that LPR and IGPR were associated independently with liver fibrosis stage, with a coefficient of 0.385 (95% confidence interval: 0.103-0.667, P = 0.007) and 14.903 (2.091-27.786, P = 0.023), respectively. CONCLUSION: LPR and IGPR were associated independently with liver fibrosis stage in treatment-naive AIH, and were superior to APRI and FIB-4 in detecting cirrhosis.

Noninvasive indicators predict advanced liver fibrosis in autoimmune hepatitis patients.

BACKGROUND: Liver biopsy is the criterion standard for diagnosing liver fibrosis, but it is not widely used to monitor liver fibrosis because of the invasiveness, risk of complications, and sample errors. Therefore, it is necessary to involve other techniques to monitor liver fibrosis or cirrhosis during clinical practice. The objective was to explore noninvasive indicators to predict advanced liver fibrosis in autoimmune hepatitis (AIH) patients. METHODS: A total of 45 AIH patients and 47 healthy controls were recruited to this retrospective study. Complete blood count and liver function tests were performed for all subjects. AIH patients were divided into "no/minimal fibrosis" group and "advanced fibrosis" group based on liver biopsy. RESULTS: AIH patients demonstrated significantly higher monocytes, MCV, RDW-CV, RDW-SD, NLR, RDW-CV/PLT, RDW-SD/PLT, TBIL, DBIL, GLB, ALT, AST, GGT, ALP, and GPR and lower WBC, neutrophils, lymphocytes, RBC, HGB, HCT, LMR, TP, ALB, and AAR compared with healthy controls. Patients with advanced fibrosis showed remarkably higher RDW-CV, RDW-SD, RDW-CV/PLT, RDW-SD/PLT, AAR, and FIB-4 and lower RBC, PLT, PCT, and ALB compared with the no/minimal fibrosis group. Logistic regression analysis showed that RDW-SD/PLT was an independent risk factor for advanced fibrosis with an OR (95% CI) of 2.647 (1.383-5.170). Receiver operating characteristic (ROC) analysis revealed that RDW-SD, RDW-CV/PLT, RDW-SD/PLT, FIB-4, and AAR had an area under the ROC curve (AUC) above 0.700 and RDW-SD/PLT had the largest AUC of 0.785 with a cutoff value of 0.239. CONCLUSION: RDW-SD, RDW-CV/PLT, RDW-SD/PLT, FIB-4, and AAR were excellent noninvasive biomarkers and RDW-SD/PLT was an independent risk factor for predicting advanced fibrosis in AIH patients.

Genome-wide comprehensive analysis of transcriptomes and small RNAs offers insights into the molecular mechanism of alkaline stress tolerance in a citrus rootstock.

Alkaline stress has serious-negative effects on citrus production. Ziyang xiangcheng (Citrus junos Sieb. ex Tanaka) (Cj) is a rootstock that is tolerant to alkaline stress and iron deficiency. Trifoliate orange (Poncirus trifoliata (L.) Raf.) (Pt), the most widely used rootstock in China, is sensitive to alkaline stress. To investigate the molecular mechanism underlying the tolerance of Cj to alkaline stress, next-generation sequencing was employed to profile the root transcriptomes and small RNAs of Cj and Pt seedlings that were cultured in nutrient solutions along a three pH gradient. This two-level regulation data set provides a system-level view of molecular events with a precise resolution. The data suggest that the auxin pathway may play a central role in the inhibitory effect of alkaline stress on root growth and that the regulation of auxin homeostasis under alkaline stress is important for the adaptation of citrus to alkaline stress. Moreover, the jasmonate (JA) pathway exhibits the opposite response to alkaline stress in Cj and Pt and may contribute to the differences in the alkaline stress tolerance and iron acquisition between Cj and Pt. The dataset provides a wealth of genomic resources and new clues to further study the mechanisms underlying alkaline stress resistance in Cj.

Long noncoding RNA PXN-AS1-L promotes non-small cell lung cancer progression via regulating PXN.

BACKGROUND: Increasingly evidences suggest that long noncoding RNAs (lncRNAs) play important roles in various cancers. LncRNA PXN-AS1-L is recently revealed to act as on oncogene in liver cancer. However, the expression, functions, and mechanisms of action of PXN-AS-L in non-small cell lung cancer (NSCLC) remain unclear. METHODS: The expression of PXN-AS1-L in primary NSCLC tissues, NSCLC bone metastasis tissues, and cell lines was measured by quantitative real-time PCR. The correlations between PXN-AS1-L expression and clinicopathological characteristics of NSCLC patients were analyzed by Pearson Chi square test and log-rank test. The roles of PXN-AS1-L in cell viability, proliferation, apoptosis, and migration of NSCLC cells, and in vivo NSCLC tumor growth were investigated by a series of gain-of-function and loss-of-function assays. The regulatory roles of PXN-AS1-L on PXN were determined by quantitative real-time PCR and western blot. RESULTS: PXN-AS1-L was up-regulated in NSCLC tissues compared with noncancerous lung tissues, and PXN-AS1-L was further up-regulated in NSCLC bone metastasis tissues. Increased expression of PXN-AS1-L was positively associated with advanced TNM stages and poor prognosis. Gain-of-function and loss-of-function assays showed that PXN-AS1-L increased cell viability, promoted cell proliferation, inhibited cell apoptosis, and promoted cell migration of NSCLC cells. Xenograft assays showed that PXN-AS1-L also promoted NSCLC tumor growth in vivo. Mechanistically, we found that PXN-AS1-L, as an antisense transcript of PXN, up-regulated the expression of PXN. PXN was also up-regulated in NSCLC tissues. The expression of PXN and PXN-AS1-L was positively correlated in NSCLC tissues. Furthermore, PXN knockdown attenuated the roles of PXN-AS1-L in increasing cell viability, promoting cell proliferation, inhibiting cell apoptosis, and promoting cell migration of NSCLC cells. CONCLUSIONS: Our data revealed that PXN-AS1-L is up-regulated and acts as an oncogene in NSCLC via up-regulating PXN. Our data suggested that PXN-AS1-L might serve as a potential prognostic biomarker and therapeutic target for NSCLC.

Inhibition of microRNA-132 attenuates inflammatory response and detrusor fibrosis in rats with interstitial cystitis via the JAK-STAT signaling pathway.

Interstitial cystitis (IC) is a heterogeneous syndrome with unknown etiology, and microRNAs (miRs) were found to be involved in IC. In our study, we aim to explore the role of miR-132 in the inflammatory response and detrusor fibrosis in IC through the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway in rat models. A rat model of IC was established and treated with the miR-132 mimic, miR-132 inhibitor, and/or JAK-STAT signaling pathway inhibitor AG490. Enzyme-linked immunosorbent assay was applied to measure the expression of interleukin (IL)-6, IL-10, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1). The urodynamic test was performed to assess urodynamic parameters, and reverse transcription quantitative polymerase chain reaction and Western blot analysis for the expression of miR-132, STAT4, suppressors of cytokine signaling 3 (SOCS3), JAK2, vascular endothelial growth factor (VEGF), IFN-γ, and TNF-α. IC rats treated with miR-132 inhibitor and AG490 had decreased collagen fiber, inflammatory cell infiltration, and mast cells, lower expression of IL-6, IL-10, IFN-γ, TNF-α, ICAM-1, collagens I and III, and alleviated urodynamic parameters and decreased expression of STAT4, VEGF, JAK2, IFN-γ, TNF-α, and increased expression of SOCS3. Taken together, our data indicate that downregulation of miR-132 alleviates inflammatory response and detrusor fibrosis in IC via the inhibition of the JAK-STAT signaling pathway.

Surgical treatment for congenital heart diseases with pulmonary artery hypertension in Down syndrome infants / 中国胸心血管外科临床杂志

@#Objective     To explore the treatment method of congenital heart disease (CHD) with pulmonary artery hypertension (PAH) in infants with Down syndrome (DS). Methods     The clinical data of 60 CHD patients with PAH from March 2015 to August 2016 in our hospital were retrospectively analyzed. There were 30 infants with DS classified as a DS group (trial group, 17 males and 13 females with a mean age of 1.15±0.25 years) and the other 30 patients without DS were classified as a control group (20 males and 10 females with a mean age of 1.24±0.30 years). All the patients underwent surgical treatment and fasudil combined with sildenafil were used to prevent pulmonary hypertension crisis postoperatively. Results     There was no significant difference in cardiopulmonary bypass time, aortic cross-clamping time, modified ultrafiltration time and the incidence of postoperative respiratory complications between the two groups. The pulmonary systolic blood pressure significantly decreased at 24 h after operation in the two groups (both P<0.05). The arterial oxygen pressure and oxygenation index of the trial group were lower than those of the control group at 6 h after operation (both P<0.05). The mechanical ventilation time and intensive care time of the trial group were significantly longer than those of the control group (P=0.007 and P=0.000, respectively). There were no reoperations or early death. Conclusion     The effects of surgical repair of CHD with PAH in infants with DS are satisfactory by grasping the indication, protecting lung function and controlling PAH in the early postoperative period, although there is a high incidence of pulmonary complications.

Clinical research of treatment with tirofiban for high-risk non-ST-segment elevation acute coronary syndrome during peri-operative intervention operation period.

The objectives of this study are to explore the clinical effects of treatment with tirofiban for high-risk non-ST-segment elevation acute coronary syndrome (NSTE ACS) during peri-operative intervention operation period and to improve the level of clinical treatment. Ninety cases of high-risk NSTE ACS patients were randomly selected from January 2011 to April 2013 as the research objects, which were divided into two groups: the control group and the observation group. The control group received conventional aspirin, clopidogrel anticoagulation, coronary angiography, and percutaneous coronary interventional (PCI) treatment, while the observation group took tirofiban treatment in addition to the treatment of control group. The differences in major adverse cardiovascular events, TIMI flow grading, and complications of the two groups were observed after treatment. There were significant differences (P < 0.05) in the distal vascular blockage of major adverse cardiovascular events, intra-operative no-reflow, reoccurrence of acute myocardial infarction and stenocardia, and post-PCI TIMI flow grades 2 and 3. But in terms of bleeding complications, and TIMI flow grades 0 and 1 before PCI and after PCI, there was no significant difference (P > 0.05). Application of tirofiban treatment for high-risk NSTE ACS during the peri-intervention period is safe and effective, which can improve TIMI flow, increase tissue perfusion, and reduce postoperative complications.

The R219K polymorphism on ATP-binding cassette transporter A1 gene is associated with coronary heart disease risk in Asia population: evidence from a meta-analysis.

A number of case-control studies have been conducted to investigate the relationship between the ATP-binding cassette transporter A1 (ABCA1) gene polymorphisms and risk of coronary heart disease (CHD). However, the results have been inconclusive. The purpose of the present study is to investigate whether this polymorphism confers significant susceptibility to CHD using a meta-analysis. We conducted searches of the published literature in PubMed, Embase, and CBM databases. 13 studies were included in our meta-analysis, involving a total of 11,678 individuals. Subgroup analyses were performed by ethnicity and cancer type. Statistically significant association between ABCA1 gene R219K polymorphism and increased CHD risk was found in total population analyses in all four genetic comparison models (OR(C vs. T) 1.19, 95% CI 1.07-1.31; P = 0.001; OR(Homozygote model) 1.28, 95% CI 1.07-1.52; P = 0.007; OR(Recessive genetic model) 1.22, 95% CI 1.04-1.44, P = 0.015; OR(Dominant model) 1.21, 95% CI 1.07-1.35; P = 0.001). In subgroup analyses based on ethnicity, the association was still significant in Asians (All P values < 0.001), but not in Caucasians (All P values > 0.05). ABCA1 R219K polymorphism is associated with CHD susceptibility, and individuals with ABCA1 have a significantly higher risk of cancer particularly in Asians.

Experimental study of acute organophosphorus compound poisoning in rabbit kidneys by ultrasonic tissue characterization.

OBJECTIVE: The purpose of this study was to investigate the value of integrated backscatter (IBS) of kidneys in acute organophosphorus compound poisoning in rabbits. METHODS: Eighteen rabbits were poisoned by dimethyl dichlorovinyl phosphate to establish animal models. Sonographic examinations were performed before (T0) and after (T1-T9) the rabbits were poisoned. The echo and size of kidneys were evaluated by 2-dimensional gray scale sonography. Changes of the renal cortex and medulla were analyzed quantitatively with IBS. RESULTS: No change of the cortex echo was found before and after poisoning. A significant change of the volume of kidneys on both sides began at T6 compared with that at T0 (P < .05). A significant change of renal length on both sides began at T7 compared with that at T0 (P < .05). The volume change was earlier than that of length. A significant change in IBS% of the renal cortex began at T5 compared with that at T0 (P < .05), whereas a significant change in IBS% of the renal medulla began at T6 compared with that at T(0) (P < .05). The change in IBS% of the renal cortex was earlier. CONCLUSIONS: More useful information provided by IBS% has been found in acute organophosphorus compound poisoning in rabbits.