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Prognosis and outcome of intrauterine treatment of fetuses with critical congenital heart disease

Chinese Medical Journal 2024年第12期137卷 1431-1436页

作者： Liqing Zhao Lei Wang Hongping Xia Yurong Wu Xianting Jiao Hong Zhu Sun Chen Kun Sun department of Pediatric Cardiology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China department of Diagnosis and Treatment Center for in utero Pediatric Disease Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China department of Neonatology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

Background:Intrauterine valvuloplasty is an innovative therapy,which promotes ventricular growth and function in some congenital heart diseases(CHDs).The technique remains challenging and can only be performed in a few *** study aimed to assess the feasibility and mid-term outcomes of fetal cardiac intervention(FCI)in fetuses with critical CHD in an experienced tertiary ***:Five fetal aortic valvuloplasty(FAV)or fetal pulmonary valvuloplasty(FPV)procedures were performed in our fetal heart center between August 2018 and May *** success was defined as crossing the aortic or pulmonary valve and balloon inflation,followed by evidence of increased blood flow across the valve and/or new ***-up clinical records and echocardiography were obtained during the prenatal and postnatal ***:Five fetuses received FAV or FPV,including critical aortic stenosis(n=2)and pulmonary atresia with intact ventricular septum(n=3).The mean maternal age was 33.0±2.6 *** median gestational age(GA)at diagnosis was 24 weeks(range,22-26 weeks).The median GA at intervention was 29 weeks(range,28-32 weeks).All five cases underwent successful or partially successful *** patient had pulmonary valve perforation without balloon *** procedure-related deaths or significant complications ***,one neonatal death occurred due to heart and renal *** median follow-up period was 29.5 months(range,8.0-48.0 months).The four surviving patients had achieved biventricular circulation,exhibited improved valve,and ventricular development at the last follow-up ***:Intrauterine FCI could be performed safely with good prognosis in critical CHD.

关键词： Fetal cardiac intervention Valvuloplasty Pulmonary atresia Critical aortic stenosis Congenital heart disease

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Clinical observation on 90 cases of primary dysmenorrhea treated by buccal acupuncture therapy:a randomized controlled study

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Journal of Traditional Chinese Medicine 2024年第1期44卷 172-181页

作者： YANG Yi YE Huijun ZHENG Huiling JIN Lihua department of Obstetrics and Gynecology the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityXinhua Hospital of Zhejiang ProvinceHangzhou 310005China

OBJECTIVE:To explore the short-term and long-term efficacy of buccal acupuncture therapy in the treatment of patients with primary dysmenorrhea(PD).METHODS:A total of 90 patients with PD who were admitted to the Second Affiliated hospital of Zhejiang University of Traditional Chinese Medicine from January 2020 to December 2021 were included in this study and randomly divided into three groups,including the observation group,the control group,and the placebo group,with 30 patients in each *** in the observation group were treated according to the syndrome types of Traditional Chinese Medicine,those in the control group were treated with Saridon,and those in the placebo group received a *** visual analog scale(VAS)scores of these patients were evaluated at different time points(before treatment,5 min after needle retention,30 min after needle retention,1 h after treatment,2 h after treatment,1 d after treatment,and 2 d after treatment).The Cox Menstrual Symptom Scale(CMSS)scores were assessed before the treatment and after three courses of ***,these two scales were also evaluated during ***,the pain score and adverse reactions of these patients were assessed during ***:After treatment,the VAS and CMSS scores in the observation group decreased significantly(P<0.05)5 and 30 min after needle retention and after ***:Buccal acupuncture therapy is verified to have short-term efficacy in the treatment of *** addition,this therapy has an immediate analgesic effect and long-term efficacy in reducing the severity and frequency of PD.

关键词： buccal acupuncture therapy primary dysmenorrhea pain score randomized controlled trial

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Novel lactylation-related signature to predict prognosis for pancreatic adenocarcinoma

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World Journal of Gastroenterology 2024年第19期30卷 2575-2602页

作者： Tian Peng Fang Sun Jia-Chun Yang Mei-Hong Cai Man-Xiu Huai Jia-Xing Pan Fei-Yu Zhang Lei-Ming Xu department of Gastroenterology Xinhua Hospital Affiliated to Shanghai Jiao Tong UniversityShanghai 200092China

BACKGROUND Lactate,previously considered a metabolic byproduct,is pivotal in cancer progression and maintaining the immunosuppressive tumor *** investigations confirmed that lactate is a primary regulator,introducing recently described post-translational modifications of histone and non-histone proteins,termed lysine *** adenocarcinomas are characterized by increased glycolysis and lactate ***,our understanding of lactylation-related genes in pancreatic adenocarcinomas remains *** To construct a novel lactylation-related gene signature to predict the survival of patients with pancreatic *** RNA-seq and clinical data of pancreatic adenocarcinoma(PDAC)were obtained from the GTEx(Genotype-Tissue Expression)and TCGA(The Cancer Genome Atlas)databases via Xena Explorer,and GSE62452 datasets from *** on lactylation-related genes were obtained from publicly available *** expressed genes(DEGs)were acquired by using R package“DESeq2”in *** COX regression analysis,LASSO Cox and multivariate Cox regressions were produced to construct the lactylation-related prognostic *** analyses,including functional enrichment,ESTIMATE,and CIBERSORT,were performed to analyze immune status and treatment responses in patients with pancreatic *** and normal human cell lines were subjected to western blot analysis under lactic acid intervention;two PDAC cell lines with the most pronounced lactylation were ***,RT-PCR was employed to assess the expression of LRGs genes;SLC16A1,which showed the highest expression,was selected for further ***16A1-mediated lactylation was analyzed by immunofluorescence,lactate production analysis,colony formation,transwell,and wound healing assays to investigate its role in promoting the proliferation and migration of PDAC *** vivo validation was performed using an established tumor *** In this stud

关键词： Pancreatic adenocarcinoma Lactylation Prognosis Immunotherapy Tumor microenvironment

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Application of immune checkpoint inhibitors and microsatellite instability in gastric cancer

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World Journal of Gastroenterology 2024年第21期30卷 2734-2739页

作者： Shi-Yan Yan Jian-Gao Fan department of Gastroenterology Xinhua HospitalShanghai Jiaotong University School of MedicineShanghai 200092China

In this editorial we comment on the article by Li published in the recent issue of the World Journal of *** focus specifically on the application of immune checkpoint inhibitors(ICIs)and microsatellite instability(MSI)in gastric cancer(GC).The four pillars of GC management have long been considered,including surgery,chemotherapy,radiotherapy and targeted ***,immunotherapy has recently emerged as a“fifth pillar”,and its use is rapidly *** are four principal strategies for tumor immunotherapy:ICIs,tumor vaccines,adoptive immunotherapy and nonspecific *** them,ICIs are the most advanced and widespread type of cancer immunotherapy for *** breakthrough results for ICIs have paved the way to a new era of cancer *** particular,inhibition of the PD-1/PD-L1 axis with ICIs,including nivolumab and pembrolizumab,has emerged as a novel treatment strategy for advanced ***,these therapies are sometimes associated with often subtle,potentially fatal immune-related adverse events(irAEs),including dermatitis,diarrhea,colitis,endocrinopathy,hepatotoxicity,neuropathy and *** must be aware of these irAEs and improve the detection of these processes to prevent inappropriate discharges,emergency department revisits,and downstream *** studies have revealed that MSI-high or mismatch-repair-deficient tumors,regardless of their primary site,have a promising response to ***,it is important to detect MSI before applying ICIs for treatment of GC.

关键词： Gastric cancer Immune checkpoint inhibitors Microsatellite instability Immunotherapy Immune-related adverse events

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Loculated pericardial hematoma diagnosed with point-of-care ultrasound

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World Journal of emergency Medicine 2024年第3期15卷 241-242页

作者： Joaquín Valle Alonso Esther Montoro Leandro Noblia emergency department Royal Bournemouth HospitalBournemouth 14450UK emergency department Hospital Santa LuciaCartagena 30202Spain

Pericardial hematoma is a rare but potentially lifethreatening consequence following cardiac surgery that requires prompt recognition and *** can present with symptoms such as chest pain,dyspnea,tachycardia,and hypotension,which may mimic other post-operative *** pericardial hematoma compressing the atria might be difficult to *** and hematoma are more common in patients receiving early anticoagulant therapy.A focused cardiac ultrasound (Fo CUS) plays a pivotal role in the diagnosis,revealing the presence of pericardial effusion and signs of cardiac *** aim of this report was to provide a prompt diagnosis of loculated pericardial hematoma via Fo CUS in the emergency department (ED).

关键词： hematoma diagnosis cardiac

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Chlorfenapyr poisoning:mechanisms,clinical presentations,and treatment strategies

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World Journal of emergency Medicine 2024年第3期15卷 214-219页

作者： Ji Cheng Yulu Chen Weidong Wang Xueqi Zhu Zhenluo Jiang Peng Liu Liwen Du emergency department Ningbo No.2 HospitalNingbo 315010China

BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus *** poisoning has a high mortality rate and is difficult to *** article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr *** RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October *** inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment *** references in the included studies were also examined to identify additional ***:We included 57 studies in this *** can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine *** fever and altered mental status are characteristic clinical presentations of chlorfenapyr *** it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and *** poisoning is diflcult to treat,and there is no specific ***:Chlorfenapyr is a new pyrrole *** it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely *** is no specific antidote for chlorfenapyr ***,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.

关键词： Chlorfenapyr poisoning Mechanism Clinical presentation Treatment

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Dexmedetomidine ameliorates diabetic intestinal injury by promoting the polarization of M2 macrophages through the MMP23B pathway

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World Journal of Diabetes 2024年第9期15卷 1962-1978页

作者： Man Lu Xiao-Wen Guo Fang-Fang Zhang Dan-Hong Wu Di Xie Feng-Qin Luo department of Anesthesiology The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Traditional Chinese Medicine)Hangzhou 310006Zhejiang ProvinceChina department of emergency Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

BACKGROUND Diabetes is often associated with gastrointestinal dysfunctions,which can lead to ***(DEX)is a commonly used sedative in perioperative diabetic patients and may affect gastrointestinal *** To investigate whether sedative doses of DEX alleviate diabetes-caused intestinal *** Sedation/anesthesia scores and vital signs of streptozotocin(STZ)-induced diabetic mice under DEX sedation were *** mice were divided into saline and DEX *** injecting sedatives intraperitoneally,tight junctions(TJs)and apoptotic levels were evaluated 24 hours later to assess the intestinal barrier *** role of DEX was validated using Villin-MMP23B flox/flox mice with intestinal epithelial *** vitro,high glucose and hyperosmolarity were used to culture Caco-2 monolayer cells with STZ *** techniques were used to monitor the barrier and mitochondrial *** MMP23B protein levels in the intestinal tissue of STZ-induced diabetic mice were significantly higher than those in the intestinal tissue of control mice,with the DEX group displaying decreased MMP23B ***-mediated TJ disruption,increased intestinal mucosal permeability,and systemic inflammation in wild-type mice might be reversed by *** Caco-2 cells,MMP23B was associated with increased reactive oxygen species accumulation,mitochondrial membrane potential depolarization,and TJ *** DEX reduces MMP23B,which may potentially contribute to STZ-induced intestinal barrier dysfunction,affecting TJ modification through mitochondrial dysfunction.

关键词： Diabetes Dexmedetomidine Intestinal barrier Piezo1 Tight junctions

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Protective mechanism of quercetin in alleviating sepsis-related acute respiratory distress syndrome based on network pharmacology and in vitro experiments

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World Journal of emergency Medicine 2024年第2期15卷 111-120页

作者： Weichao Ding Wei Zhang Juan Chen Mengmeng Wang Yi Ren Jing Feng Xiaoqin Han Xiaohang Ji Shinan Nie Zhaorui Sun department of emergency Medicine Jinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210002China department of emergency Medicine Jinling Clinical Medical College of Nanjing University of Chinese MedicineNanjing 210002China department of emergency Medicine the Affiliated Hospital of Xuzhou Medical UniversityXuzhou 221002China department of emergency Medicine Xuzhou Municipal Hospital Affiliated to Xuzhou Medical UniversityXuzhou 221000China

BACKGROUND:Sepsis-related acute respiratory distress syndrome(ARDS)has a high mortality rate,and no effective treatment is available *** is a natural plant product with many pharmacological activities,such as antioxidative,anti-apoptotic,and anti-inflammatory *** study aimed to elucidate the protective mechanism of quercetin against sepsis-related ***:In this study,network pharmacology and in vitro experiments were used to investigate the underlying mechanisms of quercetin against sepsis-related *** targets and signaling pathways of quercetin against sepsis-related ARDS were screened and were verified by in vitro ***:A total of 4,230 targets of quercetin,360 disease targets of sepsis-related ARDS,and 211 intersection targets were obtained via database *** the 211 intersection targets,interleukin-6(IL-6),tumor necrosis factor(TNF),albumin(ALB),AKT serine/threonine kinase 1(AKT1),and interleukin-1β(IL-1β)were identified as the core targets.A Gene Ontology(GO)enrichment analysis revealed 894 genes involved in the inflammatory response,apoptosis regulation,and response to *** Encyclopedia of Genes and Genomes(KEGG)enrichment analysis identified 106 *** eliminating and generalizing,the hypoxia-inducible factor-1(HIF-1),TNF,nuclear factor-κB(NF-κB),and nucleotide-binding and oligomerization domain(NOD)-like receptor signaling pathways were *** docking revealed that quercetin had good binding activity with the core ***,quercetin blocked the HIF-1,TNF,NF-κB,and NODlike receptor signaling pathways in lipopolysaccharide(LPS)-induced murine alveolar macrophage(MH-S)*** also suppressed the inflammatory response,oxidative reactions,and cell ***:Quercetin ameliorates sepsis-related ARDS by binding to its core targets and blocking the HIF-1,TNF,NF-κB,and NOD-like receptor signaling pathways to reduce inflammation,cell apoptosis,and oxidative

关键词： Quercetin Sepsis-related acute respiratory distress syndrome Network pharmacology

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Comparison between sepsis-induced coagulopathy and sepsis-associated coagulopathy criteria in identifying sepsis-associated disseminated intravascular coagulation

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World Journal of emergency Medicine 2024年第3期15卷 190-196页

作者： Huixin Zhao Yiming Dong Sijia Wang Jiayuan Shen Zhenju Song Mingming Xue Mian Shao department of emergency Medicine Zhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis *** this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis ***:Data from 419 sepsis patients were retrospectively collected from July 2018 to December *** performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or *** SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify *** SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant ***:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,*** specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting *** sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.

关键词： Sepsis Disseminated intravascular coagulation Sepsis-induced coagulopathy Sepsis-associated coagulopathy

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The use of fluoroscopy for detecting hypertensive lung edema due to prosthetic valve dysfunction: a case report

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World Journal of emergency Medicine 2024年第4期15卷 313-315页

作者： Yusuf Kantar Necmi Baykan emergency department Akçaabat Haçkalibaba State HospitalTrabzon 61060Turkiye emergency department Kayseri City HospitalKayseri 38080Turkiye

Heart valve diseases affect more than one hundred million people around the world,which are a serious cause of illness and mortality.[1]Among the valve diseases,mitral valve insufficiency ranks second in the list of valve diseases requiring surgical repair in Europe.[2]Prosthetic valve replacement is the standard treatment in cases where repair is not sufficient for valve diseases.[3]Mechanical and bioprosthetic valves can be preferred for replacement,mechanical valves are more durable and require lifelong use of *** disadvantage of bioprosthetic valves is early degeneration,and infective reoperation is required due to the formation of endocarditis.[4-5]The risk of thromboembolism,lifetime anticoagulant use and complications related to anticoagulation remain disadvantages of valve surgery.[3]The most important complication requiring urgent intervention is valve dysfunction due to *** usually occurs due to inappropriate use of the anticoagulants.[6]Surgical treatment is used for severe obstructions,such as thrombi larger than 10 *** therapy can be applied in small thrombi and in cases where surgical intervention is risky.

关键词： valve disadvantage lifetime

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