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Background: Partial anomalous pulmonary venous connection (PAPVC) without an atrial septal defect (ASD) associated with coarctation of the aortic arch is a rare congenital cardiac anomaly. This rare combination is only described in a few studies; none report the correction of these two malformations in a single surgery.Case Presentation: A 5-year-old girl was admitted to our hospital because the echocardiography revealed coarctation of the aortic arch; this diagnosis was confirmed by computed tomography (CT), which also showed her left superior pulmonary vein draining into the vertical vein without ASD (Fig. 1). She exhibited no special clinical symptoms. Her upper-limb blood pressure was approximately 110/90 mmHg, whereas her lower-limb blood pressure was approximately 75/50 mmHg.Conclusions: We surgically repaired the case of PAPVC to the vertical vein with aortic coarctation, in which the two cardiovascular malformations were corrected in a single surgery without cardiopulmonary bypass. [ABSTRACT FROM AUTHOR]

Objective-To retrospect the construction and application of the dual referral system for infertility treatment in Jiangsu Province, China. With the standard procedure to screen infertile pathogeny, those doctors of reproductive medicine with formal training can diagnose and treat patients step by step, and smoothly transfer treatment between superior and subordinate reproductive centers. Methods:The standardized diagnosis and treatment procedure of infertility and sterility and the clinical pathway of preliminary screening on the pathogeny were established. The database system, CCRM, was upgraded in the practice in our center. The advanced training course of 3 months was designed for doctors. The expert out-calls and lecture tours were scheduled in Jiangsu Province. The clinical shortcut service system, so called the Green Channel, and the demonstration clinics were well developed. Results : There were 211 309 patients undergone the preliminary screening system from January 2005 to October 2013 in our center. 21 hospitals joined the program. 1 149 patients underwent the transfer treatment, the referral rate is 2.6% (1 149/211 309). The cost of the preliminary screening on pathogeny was 1 116.4 RMB. Times of the expert out-call were 14,and 1 185 patients were diagnosed in those expert out-calls. 236 trainees finished their three-months' advanced training program; 2 529 participants finished training in 28 courses. 40 outpatient clinics of infertility were set up and 56 hospitals joined in the training of the database system. Conclusions-It is concluded from our practice that the infertility dual referral system was effectively developed in Jiangsu Province, China, and that the standardized infertility diagnosis and treatment procedure was also successfully developed. With above system and procedure and the clinical pathway of preliminary screening on the pathogeny of infertility, it is feasible to reduce the medical cost for patients, and to provide the high-quality medical service in the limited times of visiting doctors. [ABSTRACT FROM AUTHOR]

About 15% couples suffer from infertility, half of which are caused by male factors. Male infertility usually manifests as teratozoospermia, oligospermia and/or asthenospermia, of which the most severe form is azoospermia. In this review, we summarize the recent progress in the study of genetic factors involved in nonobstructive azoospermia and teratozoospermia, Recently, with the rapid development of high-throughput chips and sequencing technologies, many genetic factors of spermatogenesis have been discovered and analyzed. For the nonobstructive azoospermia, genome-wide association studies (GWAS) and high-throughput sequencing revealed many risk loci of nonobstructive azoospermia. For the teratozoospermia, the application of whole-exome sequencing (WES) revealed a series of disease-causing genes, greatly enriching our knowledge of teratozoospermia including multiple morphological abnormalities of the flagella (MMAF). The discovery of lots of disease genes helped the characterization of the pathological mechanisms of male infertility. Therefore, a comprehensive and in-depth understanding of genetic factors in spermatogenesis abnormalities will play important roles in the clinical diagnosis, treatment and genetic counseling of male infertility.

Background: To reveal detailed histopathological changes, virus distributions, immunologic properties and multi-omic features caused by SARS-CoV-2 in the explanted lungs from the world's first successful lung transplantation of a COVID-19 patient., Materials and Methods: A total of 36 samples were collected from the lungs. Histopathological features and virus distribution were observed by optical microscope and transmission electron microscope (TEM). Immune cells were detected by flow cytometry and immunohistochemistry. Transcriptome and proteome approaches were used to investigate main biological processes involved in COVID-19-associated pulmonary fibrosis., Results: The histopathological changes of the lung tissues were characterized by extensive pulmonary interstitial fibrosis and haemorrhage. Viral particles were observed in the cytoplasm of macrophages. CD3 + CD4 - T cells, neutrophils, NK cells, γ/δ T cells and monocytes, but not B cells, were abundant in the lungs. Higher levels of proinflammatory cytokines iNOS, IL-1β and IL-6 were in the area of mild fibrosis. Multi-omics analyses revealed a total of 126 out of 20,356 significant different transcription and 114 out of 8,493 protein expression in lung samples with mild and severe fibrosis, most of which were related to fibrosis and inflammation., Conclusions: Our results provide novel insight that the significant neutrophil/ CD3 + CD4 - T cell/ macrophage activation leads to cytokine storm and severe fibrosis in the lungs of COVID-19 patient and may contribute to a better understanding of COVID-19 pathogenesis., (© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)

Background: The role of ERBB4 in liver disease has seldom been reported. This study aims to find genetic markers at ERBB4 for chronic hepatitis B virus (HBV) infection and determine the role of ERBB4 in liver injury., Methods: We selected and genotyped three single nucleotide polymorphisms and one insertion/deletion (Ins/Del) at the 5' and 3' untranslated region (UTR) of ERBB4 in a case-control study including 1344 pairs of HBV carriers and HBV natural clearance subjects. The luciferase reporter system was applied to study the regulative role of Ins/Del on ERBB4. Further, ERBB4 knockout mice were used to study the role of ERBB4 in liver injury. Proteomic quantification was performed by HPLC-MS/MS analysis to identify liver protein profile change between liver-specific ERBB4 knockout and control mice., Results: rs6147150 Ins/Del and rs1836724 T>C at the 3' UTR of ERBB4 were associated with reduced risk of chronic HBV infection (P = 0.002 and 0.004, respectively). Besides, the 12bp deletion at the 3' UTR increased ERBB4 expression due to lacking let-7c binding site. In addition, loss of ERBB4 led to more severe acute or chronic inflammation in mouse liver injury models. Further, quantitative proteomic analysis and data from the cancer genome atlas revealed that ACLY, an enzyme key for de novo lipogenesis, was negatively correlated with ERBB4., Conclusions: ERBB4 plays protective role from liver injury and its 3'UTR genetic variants could be genetic markers for chronic HBV infection.

Epstein-Barr virus (EBV)-DNA is detected in the blood of some persons with chronic lymphocytic leukemia (CLL) at diagnosis. Whether this is important in the development or progression of CLL is controversial. We interrogated associations between blood EBV-DNA copy number and biological and clinical variables in 243 new-diagnosed consecutive subjects with CLL. Quantification of EBV-DNA copies was done by real-time quantitative PCR (RQ-PCR). All subjects had serological evidence of prior EBV-infection. However, only 24 subjects (10%) had a EBV-DNA-positive test at diagnosis. EBV-DNA-positive subjects at diagnosis had lower hemoglobin concentrations and platelet levels, higher thymidine kinase-1 and serum ferritin levels, un-mutated IGHV genes and a greater risk of Richter transformation compared with EBV-DNA-negative subjects. Percent CD20-, CD148- and ZAP70-positive cells and mean fluorescence intensity (MFI) of each cluster designation were also increased in EBV-DNA-positive subjects at diagnosis. EBV-DNA test positivity was associated with a briefer time-to-treatment interval (HR 1.85; [95% confidence interval, 1.13, 3.03]; P=0.014) and worse survival (HR 2.77; [1.18, 6.49]; P=0.019). Reduction in EBV copies was significantly associated with therapy-response. A positive blood EBV-DNA test at diagnosis and sequential testing of EBV copies during therapy were significantly associated with biological and clinical variables, time-to-treatment, therapy-response and survival. If validated these data may be added to CLL prognostic scoring systems.

Photocatalytic degradation kinetics of acetamiprid was studied by both of single-variable-at-a-time (SVAT) and central composite design (CCD) experiments based on four factors, such as catalyst dosages, substrate concentration, temperature and pH values. The results indicated that degradation of acetamiprid followed pseudo first-order kinetics by Langmuir-Hinshelwood model, increased with the increasing of temperature and the decreasing of substrate concentration. The photocatalytic degradation kinetic rate of acetamiprid was low in acid solutions, while high in weak acidic and alkaline solutions. After studying the synergistic effects of these four classic parameters, the optimal experiment conditions for photocatalytic degradation of acetamiprid were obtained as follows: TiO2 at 2.30 g x L(-1), initial acetamiprid concentration of 90.0 μmol x L(-1), temperature of 37.5 degrees C and pH value at 5.0. Lastly, 7 degradation intermediates of acetamiprid were detected during photocatalytic process by HPLC, and 6 of them exhibited more polar than the parent molecule.