中南大学学报(医学版)最新文献

{"title":"Association of adipocytokine pathway gene polymorphisms with NAFLD in obese children.","authors":"Jie Wang, Xiongfeng Pan, Jia Wei, Xiongwei Li, Haixiang Zhou, Ning'an Xu, Rutong Kang, Yan Zhong, Jiayou Luo","doi":"10.11817/j.issn.1672-7347.2024.230098","DOIUrl":"10.11817/j.issn.1672-7347.2024.230098","url":null,"abstract":"<p><strong>Objectives: </strong>Non-alcoholic fatty liver disease (NAFLD) has significant genetic susceptibility. Adipocytokines play a crucial role in NAFLD development by participating in insulin resistance and hepatic steatosis. However, the association between adipocytokine pathway genes and NAFLD remains unclear. This study aims to explore the association of gene polymorphisms in the adipocytokine pathway and their interactions with NAFLD in obese children.</p><p><strong>Methods: </strong>A case-control study was conducted, dividing obese children into NAFLD and control groups. Peripheral venous blood (2 mL) was collected from each participant for DNA extraction. A total of 14 single nucleotide polymorphisms (SNP) in the adipocytokine pathway were genotyped using multiplex PCR and high-throughput sequencing. Univariate and multivariate Logistic regression analyses were used to assess the association between SNP and NAFLD in obese children. Dominant models were used to analyze additive and multiplicative interactions via crossover analysis and Logistic regression. Generalized multifactor dimensionality reduction (GMDR) was used to detect gene-gene interactions among the 14 SNPs and their association with NAFLD in obese children.</p><p><strong>Results: </strong>A total of 1 022 children were included, with 511 in the NAFLD group and 511 in the control group. After adjusting for age, gender, and BMI, multivariate Logistic regression showed that <i>PPARG</i> rs1801282 was associated with NAFLD in the obese children in 3 genetic models: heterozygote model (CG vs CC, <i>OR</i>=0.58, 95% <i>CI</i> 0.36 to 0.95, <i>P</i>=0.029), dominant model (GG+CG vs CC, <i>OR</i>=0.62, 95% <i>CI</i> 0.38 to 1.00, <i>P</i>=0.049), and overdominant model (CC+GG vs CG, <i>OR</i>=1.72, 95% <i>CI</i> 1.06 to 2.80, <i>P</i>=0.028). <i>PRKAG2</i> rs12703159 was associated with NAFLD in 4 genetic models: heterozygous model (CT vs CC, <i>OR</i>=1.51, 95% <i>CI</i> 1.10 to 2.07, <i>P</i>=0.011), dominant model (CT+TT vs CC, <i>OR</i>=1.50, 95% <i>CI</i> 1.10 to 2.03, <i>P</i>=0.010), overdominant model (CC+TT vs CT, <i>OR</i>=0.67, 95% <i>CI</i> 0.49 to 0.92, <i>P</i>=0.012), and additive model (CC vs CT vs TT, <i>OR</i>=1.40, 95% <i>CI</i> 1.07 to 1.83, <i>P</i>=0.015). No significant multiplicative or additive interaction between <i>PPARG</i> rs1801282 and <i>PRKAG2</i> rs12703159 was found in association with NAFLD. GMDR analysis, adjusted for age, gender, and BMI, revealed no statistically significant interactions among the 14 SNPs (all <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>Mutations in <i>PPARG</i> rs1801282 and <i>PRKAG2</i> rs12703159 are associated with NAFLD in obese children. However, no gene-gene interactions among the SNP are found to be associated with NAFLD in obese children.</p>","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 5","pages":"775-783"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of missed MRI diagnosis of radiotherapy-induced temporal lobe injury in nasopharyngeal carcinoma.","authors":"Ruiting Chen, Linmei Zhao, Fangxue Yang, Gaofeng Zhou, Dongcui Wang, Qing Zhao, Weihua Liao","doi":"10.11817/j.issn.1672-7347.2024.230574","DOIUrl":"10.11817/j.issn.1672-7347.2024.230574","url":null,"abstract":"<p><strong>Objectives: </strong>Radiotherapy is the primary treatment for nasopharyngeal carcinoma, but it frequently leads to radiotherapy-induced temporal lobe injury (RTLI). Magnetic resonance imaging (MRI) is the main diagnostic method for RTLI after radiotherapy for nasopharyngeal carcinoma, but it is prone to missed diagnoses. This study aims to investigate the causes of missed diagnoses of RTLI in nasopharyngeal carcinoma patients undergoing MRI after radiotherapy.</p><p><strong>Methods: </strong>Clinical and MRI data from nasopharyngeal carcinoma patients diagnosed and treated with radiotherapy at Xiangya Hospital of Central South University, from January 2010 to April 2021, were collected. Two radiologists reviewed all head and neck MRIs (including nasopharyngeal and brain MRIs) before and after radiotherapy of identify cases of late delayed response-type RTLI for the first time. If the original diagnosis of the initial RTLI in nasopharyngeal carcinoma patients did not report temporal lobe lesions, it was defined as a missed diagnosis. The first diagnosis of RTLI cases was divided into a missed diagnosis group and a non-missed diagnosis group. Clinical and imaging data were compared between the 2 groups, and multivariate logistic regression analysis was used to identify independent risk factors for MRI missed diagnoses of initial RTLI.</p><p><strong>Results: </strong>A total of 187 nasopharyngeal carcinoma with post-radiotherapy RTLI were included. The original diagnostic reports missed 120 cases and accurately diagnosed 67 cases, with an initial RTLI diagnosis accuracy rate of 35.8% and a missed diagnosis rate of 64.2%. There were statistically significant differences between the missed diagnosis group and the non-missed diagnosis group in terms of lesion size, location, presence of contralateral temporal lobe lesions, white matter high signal, cystic degeneration, hemorrhage, fluid attenuated inversion recovery (FLAIR), and examination site (all <i>P</i><0.05). Multivariate logistic regression analysis showed that lesions ≤25 mm, non-enhancing lesions, lesions without cystic degeneration or hemorrhage, lesions located only in the medial temporal lobe, and MRI examination only of the nasopharynx were independent risk factors for missed MRI diagnosis of initial RTLI (all <i>P</i><0.05).</p><p><strong>Conclusions: </strong>The missed diagnosis of initial RTLI on MRI is mainly related to lesion size and location, imaging characteristics, and MRI examination site.</p>","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 5","pages":"698-704"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics, effectiveness and cost of different treatment methods for invasive <i>Klebsiella pneumonia</i>e liver abscess syndrome.","authors":"Qin Hu, Jingying Lu, Binbin Deng, Xuemei Tang, Zhouhua Hou","doi":"10.11817/j.issn.1672-7347.2024.240063","DOIUrl":"10.11817/j.issn.1672-7347.2024.240063","url":null,"abstract":"<p><strong>Objectives: </strong>Bacterial liver abscess is one of the common infectious diseases of the digestive system. Invasive <i>Klebsiella pneumoniae</i> liver abscess syndrome (IKLAS) refers to cases where, in addition to liver abscess, there are migratory infections foci or other invasive manifestations. The clinical characteristics and risk factors of IKLAS are not fully elucidated, and there is a lack of research on the effectiveness and cost-effectiveness of different treatment methods. This study aims to compare the clinical characteristics of patients with IKLAS and non-IKLAS, and explore effective and economical treatment methods.</p><p><strong>Methods: </strong>This retrospective study collected medical records of patients with <i>Klebsiella pneumoniae</i> liver abscess treated at Xiangya Hospital of Central South University from January 2010 to December 2023. A total of 201 patients were included, dividing into an IKLAS group (<i>n</i>=37) and a non-IKLAS group (<i>n</i>=164). Differences in demographics, symptoms and signs, laboratory indicators, imaging characteristics, comorbidities, treatment methods, treatment outcomes, and direct treatment costs between 2 groups were analyzed. The study also compared the effectiveness and costs of different treatment methods.</p><p><strong>Results: </strong>Compared with the non-IKLAS group, the proportion of patients with diabetes, Quick Sequential Organ Failure Assessment (qSOFA)≥2, immune deficiency, anemia, and thrombocytopenia in the IKLAS group was higher, and the level of procalcitonin at the onset in the IKLAS group was also higher (all <i>P</i><0.05). In terms of symptoms and signs, the IKLAS group had a higher proportion of visual abnormalities and a lower proportion of complaints of abdominal pain (both <i>P</i><0.05). In terms of complications, the incidence of combined pleural effusion, pulmonary infection, acute renal failure, respiratory failure, and multiple organ failure was higher in the IKLAS group (all <i>P</i><0.05). The IKLAS group had a higher proportion of patients treated with antibiotics alone (24.32% vs 11.59%), while the non-IKLAS group had a higher proportion of patients treated with antibiotics combined with puncture and drainage (86.59% vs 64.86%, both <i>P</i><0.05). The overall effective rate of the IKLAS group (83.78%) was lower than that of the non-IKLAS group (95.73%), and the treatment and drug costs were higher (all <i>P</i><0.05). The treatment method of antibiotics combined with surgical resection of infectious foci showed a 100% improvement rate, antibiotics combined with abscess puncture and drainage had an 84.9% improvement rate, and in antibiotics alone had an 82.1% improvement rate, with statistical differences among the 3 treatment methods (<i>P</i><0.05). In terms of treatment costs, antibiotics alone were the most expensive (<i>P</i><0.05).</p><p><strong>Conclusions: </strong>Patients with IKLAS have poorer prognosis and higher direct medical c","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 5","pages":"748-757"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virulence gene distribution and molecular epidemiological characteristics of carbapenem-resistant <i>Klebsiella pneumoniae</i> in the ICU.","authors":"Yaxuan Huang, Yihan Cai, Wanxia He, Liyan Zhang, Yue Zhao","doi":"10.11817/j.issn.1672-7347.2024.240029","DOIUrl":"10.11817/j.issn.1672-7347.2024.240029","url":null,"abstract":"<p><strong>Objectives: </strong>The drug-resistant genes carried by carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) limit clinical treatment options, and its virulence genes severely affect patient prognosis. This study aims to investigate the distribution of virulence genes, capsular serotypes, and molecular epidemiological characteristics of CRKP in ICU, to understand the characteristics of CRKP infections in ICU, and to provide a scientific basis for effective monitoring and control of CRKP infections in ICU.</p><p><strong>Methods: </strong>A total of 40 non-duplicate strains of CRKP isolated from the ICU of Guangdong Provincial People's Hospital between January 2021 and December 2022 were collected and analyzed. Whole-genome sequencing was used to analyze the distribution of resistance genes, virulence genes, and capsular serotypes of the strains. The sequences of 7 housekeeping genes of CRKP genome were uploaded to the <i>Klebsiella pneumoniae</i> (KPN)multilocus sequence typing (MLST) database to determine the sequence types (STs) of the strains.</p><p><strong>Results: </strong>The age of the 40 ICU CRKP-infected patients was (69.03±17.82) years old, with various underlying diseases, and there were 20 patients with improved clinical outcome and 20 patients with death. The isolated strains primarily originated from mid-stream urine and bronchoalveolar lavage fluid. Whole-genome sequencing results revealed that the strains predominantly carried <i>bla</i>_KPC-1 (29 strains, 72.5%) and <i>bla</i>_NDM-1 (6 strains, 15.0%), with 5 strains carrying both <i>bla</i>_KPC-1 and <i>bla</i>_NDM-1. Various virulence genes were detected, among which the carriage rates of genes such as <i>entA</i>, <i>entB</i>, <i>entE</i>, <i>entS</i>, <i>fepA</i>, <i>fepC</i>, <i>fepG</i>, <i>yag</i>/<i>ecp</i>, and <i>ompA</i> reached 100%, while the carriage rates of genes such as <i>entD</i>, <i>fimB</i>, <i>iroB</i>, <i>iroD</i>, <i>fes</i>,and <i>pla</i> were low. The CRKP strains isolated from ICU were predominantly ST11 (27 cases, 67.5%), with KL64 being the main capsular serotype (29 cases, 72.5%). A total of 23 ST11-KL64 CRKP strains were detected, accounting for 57.5%.</p><p><strong>Conclusions: </strong>The main type of ICU CRKP is ST11-KL64, carrying various virulence genes, primarily those related to iron absorption. Furthermore, <i>bla</i>_KPC has shifted from <i>bla</i>_KPC-2 to <i>bla</i>_KPC-1. Therefore, close monitoring of the molecular epidemiological changes of CRKP is necessary, and strict control measures should be implemented to effectively curb the occurrence of CRKP infections.</p>","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 5","pages":"730-736"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of spontaneous age-related cataract in <i>Microtus fortis</i>.","authors":"Tianqiong He, Junkang Zhou, Yixin Wen, Qian Liu, Wenling Zhi, Wenhao Yang, Shuangyan He, Lingxuan Ouyang, Xiaobo Xia, Zhijun Zhou","doi":"10.11817/j.issn.1672-7347.2024.230534","DOIUrl":"10.11817/j.issn.1672-7347.2024.230534","url":null,"abstract":"<p><strong>Objectives: </strong>Age-related cataract is the most common type of adult cataract and a leading cause of blindness. Currently, there are few reports on the establishment of animal models for age-related cataract. During the experimental breeding of <i>Microtus fortis</i> (<i>M. fortis</i>), we first observed that <i>M. fortis</i> aged 12 to 15 months could naturally develop cataracts. This study aims to explore the possibility of developing them as an animal model for age-related cataract via identifing and analyzing spontaneous cataract in <i>M. fortis</i>.</p><p><strong>Methods: </strong>The 12-month-old healthy <i>M. fortis</i> were served as a control group and 12-month-old cataractous <i>M. fortis</i> were served as an experimental group. The lens transparency was observed using the slit-lamp biomicroscope. Hematoxylin and eosin staining was used to detect pathological changes in the lens. Biochemical detection methods were applied to detect blood routine, blood glucose levels, the serum activities of superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in both groups. Finally, real-time RT-PCR was used to detect the transcription levels of cataract-related genes in the lens of 2 groups.</p><p><strong>Results: </strong>Compared with the control group, the lens of cataract <i>M. fortis</i> showed severely visible opacity, the structure of lens was destroyed seriously, and some pathological damage, such as swelling, degeneration/necrosis, calcification, hyperplasia, and fiber liquefaction were found in lens epithelial cells (LECs). The fibrous structure was disorganized and irregularly distributed with morgagnian globules (MGs) aggregated in the degenerated lens fibers. There was no statistically significant difference in blood glucose levels between the experimental and control groups (<i>P></i>0.05). However, white blood cell (WBC) count (<i>P<</i>0.05), lymphocyte count (<i>P<</i>0.01), and lymphocyte ratio (<i>P<</i>0.05) were significantly decreased, while neutrophil percentage (<i>P<</i>0.05) and monocyte ratio (<i>P<</i>0.01) were significantly increased. The serum activities of SOD and GSH-Px (both <i>P<</i>0.05) were both reduced. The mRNAs of cataract-related genes, including <i>CRYAA</i>, <i>CRYBA1</i>, <i>CRYBB3, Bsfp1</i>, <i>GJA3</i>, <i>CRYBA2</i>, <i>MIP</i>, <i>HspB1</i>, <i>DNase2B,</i> and <i>GJA8</i>, were significantly downregultaed in the lenses of the experimental group (all <i>P<</i>0.05).</p><p><strong>Conclusions: </strong>There are significant differences in lens pathological changes, peroxidase levels, and cataract-related gene expression between cataract and healthy <i>M. fortis</i>. The developed cataract spontaneously in <i>M. fortis</i> is closely related to age, the cataract <i>M. fortis</i> might be an ideal animal model for the research of age-related cataract.</p>","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 4","pages":"553-561"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of hypopharyngeal amyloidosis by digestive endoscopy.","authors":"Ling He, Wei Su, Lingli Li, Qiao Zhou, Qiuling Zhao, Hongping Li","doi":"10.11817/j.issn.1672-7347.2024.230483","DOIUrl":"10.11817/j.issn.1672-7347.2024.230483","url":null,"abstract":"<p><p>Amyloidosis is a rare disease. This paper reports a case of localized secondary hypopharyngeal amyloidosis presenting with pulmonary tuberculosis as the initial symptom. The patient lacked specific clinical manifestations and primarily exhibited symptoms such as cough, sputum production, acid reflux, belching, and abdominal pain. Chest CT indicated bronchiectasis with infection and pulmonary tuberculosis. Digestive endoscopy revealed a white mucosal elevation at the right pyriform sinus of the hypopharynx. Pathological diagnosis confirmed amyloid deposits in the hypopharyngeal mucosal tissue. The patient tested positive for anti-amyloid A antibodies, Congo red staining (+), and periodate Schiff staining (+). Amyloidosis commonly affects the digestive system and may have various etiologies, often presenting with symptoms that overlap with other digestive system diseases, leading to frequent misdiagnosis and missed optimal treatment opportunities. The hypopharynx, a highly folded and narrow chamber that serves as a common passage for the digestive and respiratory tracts, can be effectively evaluated for amyloidosis using digestive endoscopy.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"49 4","pages":"643-648"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application progress of latent class growth models in dynamic prevention and control strategies for acquired immunodeficiency syndrome.","authors":"Mimi Zhai, Yamin Li, Sushun Liu, Yunxia Li, Yiting Liu, Li Li, Xianyang Lei","doi":"10.11817/j.issn.1672-7347.2024.230437","DOIUrl":"10.11817/j.issn.1672-7347.2024.230437","url":null,"abstract":"<p><p>The prevention and control requirements for HIV/AIDS vary significantly among different populations, posing substantial challenges to the formulation and implementation of intervention strategies. Dynamically assessing the heterogeneity and disease progression trajectories of various groups is crucial. Latent class growth model (LCGM) serves as a statistical approach that fits a longitudinal data into N subgroups of individual development trajectories, identifying and analyzing the progression paths of different subgroups, thereby offering a novel perspective for disease control strategies. LCGM has shown significant advantages in the application of HIV/AIDS prevention and control, especially in gaining a deeper understanding and analysis of epidemiological characteristics, risk behaviors, psychological research, heterogeneity in testing, and dynamic changes. Summarizing the advantages and limitations of applying LCGM can provide a reliable basis for precise prevention and control of HIV/AIDS.</p>","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 4","pages":"621-627"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic features and pathological ultrastructural characteristics of fetal interruption of aortic arch.","authors":"Haichen Guan, Xiaofang Wang, Qichang Zhou, Leiqi Tian, Zhongcheng Yang, Si Yang","doi":"10.11817/j.issn.1672-7347.2024.230527","DOIUrl":"10.11817/j.issn.1672-7347.2024.230527","url":null,"abstract":"<p><strong>Objectives: </strong>Interruption of aortic arch (IAA) is a rare congenital heart disease. This study aims to investigate echocardiographic features and pathological ultrastructural characteristics of fetal IAA and to further analyze its pathological evolution.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on prenatal echocardiographic, post-surgical, or autopsy findings of fetuses prenatally diagnosed with IAA. Prenatal echocardiographic tracking was used to observe the internal diameters and Z-scores of different segments of the aortic arch and the changes in the narrowed section. These observations were combined with autopsy and pathological findings to explore the potential intrauterine evolution of IAA and its cytological basis.</p><p><strong>Results: </strong>The study included 34 fetuses with IAA, with 3, 3, and 28 fetuses prenatally diagnosed with aortic arch dysplasia (AAD), coarctation of aorta (CoA), and IAA, respectively. The 3 AAD and 3 CoA fetuses chose termination of pregnancy 1 to 2 weeks after prenatal ultrasound diagnosis, and autopsy confirmed IAA. Among the 28 fetuses prenatally diagnosed with IAA, 6 cases of CoA progressively worsened, eventually evolving into type A IAA as observed through echocardiographic follow-up. The remaining 22 cases were diagnosed as IAA on the first prenatal ultrasound. Postnatal surgery corrected 3 cases, while 27 cases opted for pregnancy termination, and 4 cases resulted in intrauterine death. Echocardiographic features of the fetal IAA included a significantly smaller left ventricle compared with the right or negligible difference on the four-chamber view, a significantly smaller aorta than the pulmonary artery on the three-vessel view, and a lack of connection between the aorta and the descending aorta on the three-vessel-trachea and aortic arch views. The aortic arch appears less curved and more rigid, losing the normal \"V\" shape between the aorta, ductus arteriosus, and descending aorta. Color Doppler ultrasound showed no continuous blood flow signal at the interruption site, with reversed blood flow visible in the ductus arteriosus. Transmission electron microscopy of 7 IAA fetuses revealed numerous disorganized smooth muscle cells between the elastic membranes near the aortic arch interruption site, significantly increased in number compared with the proximal ascending aorta. The elastic membranes were thicker and more twisted near the interruption site. The interruption area lacked normal endothelial cells and lumen, with only remnants of necrotic endothelial cells, disorganized short and thick elastic membranes, and randomly arranged smooth muscle cells.</p><p><strong>Conclusions: </strong>Prenatal echocardiography is the primary diagnostic tool for fetal IAA. Post-surgical follow-up and autopsy help identify complications and disease characteristics, enhancing diagnostic accuracy. Some fetal IAA may evolve from AAD or CoA, with potential pathogenesis r","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 4","pages":"595-602"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal ultrasound diagnosis and quality control of fetal nuchal translucency.","authors":"Xiaohua Yuan, Yimei Fu","doi":"10.11817/j.issn.1672-7347.2024.240005","DOIUrl":"10.11817/j.issn.1672-7347.2024.240005","url":null,"abstract":"<p><strong>Objectives: </strong>In clinical ultrasound examinations, it is challenging to perform quality control on the images of each fetal nuchal translucency (NT) and crown-rump length (CRL). However, small measurement differences can increase the probability of false-positive or false-negative diagnosis. Therefore, it is necessary to establish a quality control system for fetal NT examination. This study aims to control the quality of fetal NT and CRL measurements, evaluate the accuracy of ultrasound physicians in early pregnancy NT measurements, and analyze the impact of increased fetal structure screening on the detection rate of chromosomal abnormalities.</p><p><strong>Methods: </strong>Data were collected from cases before and after 12 months of NT examination quality control, with 2 214 before quality control and 2 538 cases after quality control. Three quality control data metrics were analyzed: NT multiple of median (NT-MoM), standard deviation (SD) of log₁₀MoM [(SD) log₁₀MoM], and the slope of NT on CRL (SNC). The performance of NT measurements was monitored through the individual CRL NT-MoM within the 0.9-1.1 MoM range of the normal median curve, while grouped based on different years of experience (<3 years, 3-6 years, >6 years), and NT-MoM values among these groups were compared. Data on NT thickening, structural anomalies, and chromosomal abnormalities were retrospectively analyzed during the quality control period.</p><p><strong>Results: </strong>According to the curve equation of the American NTQR project group, the NT-MoM value before quality control was 0.921 7 MoM, the (SD) log₁₀MoM value was 0.091 92, and the SNC value was 12.20%. After quality control, the NT-MoM value was 0.948 3 MoM, the (SD) log₁₀MoM value was 0.094 81, and the SNC value was 11.43%. The comparison of NT-MoM values before and after quality control showed a statistically significant difference (<i>P</i><0.000 1). The comparison of NT-MoM values measured by ultrasound physicians with different years of experience before and after quality control also showed statistically significant differences (<i>P</i><0.000 1). The NT-MoM values for the 3-6 years and >6 years groups were higher after quality control (<i>P</i><0.05), while the <3 years group showed no significant difference before and after quality control (<i>P</i>>0.05). After quality control, cases of NT thickening without significant structural abnormalities accounted for 19.05%, NT thickening with structural abnormalities accounted for 47.62%, and NT normal with structural abnormalities accounted for 33.33%. There were 36 cases of fetal heart abnormalities, accounting for 20.34% of the total abnormality rate, with a positive rate of 36% in chromosome tests.</p><p><strong>Conclusions: </strong>After quality control, ultrasound physicians measure NT more accurately, but differences among measurements remain. Measurements by experienced ultrasound physicians ","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 4","pages":"603-610"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application progress of exergames in health interventions for the elderly.","authors":"Xi Chen, Hongting Ning, Shuang Wu, Lina Wu, Dian Jiang, Yifei Chen, Zeng Cao, Hui Feng","doi":"10.11817/j.issn.1672-7347.2024.230420","DOIUrl":"10.11817/j.issn.1672-7347.2024.230420","url":null,"abstract":"<p><p>With the aging population in China, health issues among the elderly are becoming increasingly prominent, leading to a rapidly growing demand for health interventions for the elderly. Exergames are one of the important emerging methods in the field of health interventions for the elderly, widely used and yielding positive results. While research on exergames is well-established abroad, it is still in its infancy in China, lacking reports on the types, interaction forms, intervention content, application status, and effectiveness of exergames. Exergames are suitable for widespread use among the elderly in China, and there is a need to accelerate the development and application of exergames in the field of health interventions for the elderly in China.</p>","PeriodicalId":39801,"journal":{"name":"Journal of Central South University (Medical Sciences)","volume":"49 4","pages":"534-540"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}