OBJECTIVE:Autologous pericardium (AP), the most common repair material used in tricuspid valve (TV) repair, has variable clinical outcomes with different treatments. To test this, we performed a long-term implantation porcine study to systematically evaluate the performance of fresh AP (FAP) and glutaraldehyde-treated AP (GAP) in TV repair. METHODS:Twenty-six Bama pigs were to undergo TV septal leaflet repair and chordae tendineae reconstruction using FAP patches (n = 6), GAP patches (n = 6), and half-half mixed AP patches (n = 14) under cardiopulmonary bypass. Heart and TV function were evaluated by echocardiograph and laboratory methods immediately, 1, 3, and 9 months postimplant. Implanted AP was evaluated 9 months after operation by morphologic, histologic, and calcification examination. Outcomes were compared using t tests and mixed-effects linear regression analysis. RESULTS:All 26 animals underwent successful TV operations and survived 9 months after the operation. Echocardiographic analysis indicated comparable heart functions over the follow-up period but TV regurgitation class with GAP was significantly higher (P = .03) than the other 2 groups 1 month postoperation. After 9 months, the length of leaflets of pigs in the FAP and GAP groups were statistically reduced by 30.21% and 47.40%, respectively (P < .01). Patch thickness in the FAP and GAP groups increased 4.98 times and 7.21 times and were statistically significant (P = .02). The lengths of chordae tendineae in FAP and GAP groups were reduced by 61.19% and 25.96%, respectively (P < .01). Compared with the GAP group, FAP group pigs demonstrated a more homogenous contribution of collagen and elastic fibers in Elastica-van Gieson staining and less calcification in von Kossa staining. Hematoxylin and eosin staining and scanning electron microscopy showed comparable endothelial cell layers on FAP and GAP patches. The mean tissue calcium content of FAP and GAP patches was 19.32 ± 1.67 mg/g and 56.10 ± 3.75 mg/g, respectively (P < .01). CONCLUSIONS:AP is a reliable material for TV repair. An oversized FAP patch proved to be a better option in tricuspid leaflet repair, whereas GAP performed better in TV chordae tendineae reconstruction.

OBJECTIVE:To analyze clinical outcomes and prognosis under different treatment strategies for myocardial bridging (MB) patients, providing evidence to optimize clinical decision-making. METHODS:A retrospective study was conducted on 243 patients diagnosed with MB by coronary angiography at our institution. Of them, 77 patients underwent surgery (group A), and were divided into group A1 (n = 31, compression ≥70%) and group A2 (n = 46, combined with other heart surgeries). The remaining 166 patients underwent medical treatment and were divided into group B1 (n = 125, compression <70%) and group B2 (n = 41, compression ≥70%). The quality of life, mortality, and major adverse cardiac events were analyzed for each group. RESULTS:Mean follow-up was 55.6 months in Group A and 85.3 months in Group B. The10-year cumulative survival rates for group A1, A2, B1, B2 were 95%, 92.1%, 93.4%, and 88.2%, and the 10-year rates of freedom from major adverse cardiac events in these groups were 89.7%, 85.0%, 74.4%, and 67.8%, respectively. For patients with isolated MB and systolic compression ≥70%, the incidence of major adverse cardiac events was significantly higher than in group B2, compared with group A1 (P = .01). Seattle Angina Questionnaire (SAQ) scores improved significantly after treatment across all groups (P < .01). CONCLUSIONS:For patients with isolated MB and systolic coronary compression ≥70%, and refractory to medical therapy, myotomy had better outcomes than medical therapy. In cases with MB coexisting with other cardiac diseases, myotomy with other cardiac surgeries can achieve satisfactory outcomes. For symptomatic patients with isolated MB and systolic coronary compression <70%, medical treatment can yield good outcomes.

Aim: Congenital heart defects (CHDs) are a major component of heterotaxy syndrome (HS), contributing significantly to high morbidity and mortality. The anatomical variability, surgical complexity, and poor prognosis of HS-associated CHDs present major clinical challenges. Material and Methods: We retrospectively reviewed 292 patients diagnosed with HS and CHDs at The First Hospital of Tsinghua University between January 2014 and December 2023. Demographic information and cardiac imaging data were collected to analyze the spectrum of cardiac malformations, spleen anatomy, sex distribution, and the frequency and distribution of major structural abnormalities. Results: The cohort included 292 patients (mean age 6.8±8.7 years), with females accounting for 40.8%. Dextrocardia was present in 50%. The asplenia type was most common (42.8%), followed by unisplenia (41.8%) and polysplenia (15.4%). The most frequent cardiac malformations were single ventricle (61.9%), conotruncal anomalies (54.5%), and pulmonary stenosis (42.8%). The overall incidence of anomalous pulmonary venous connection was 7.8%, with total anomalous pulmonary venous connection (TAPVC) accounting for 6.8%. Gender analysis revealed a significantly higher proportion of males in the asplenia group (66.4% vs. 33.6%, P<0.05) and in the unisplenia group (59.0% vs. 41.0%, P<0.05). Although females were more frequent in the polysplenia group (57.8% vs. 42.2%), the difference was not statistically significant (P>0.05). Conclusion: HS with CHDs presents with complex and diverse anatomical abnormalities and is associated with challenging management and poor prognosis. This ten-year single-center study provides a comprehensive overview of the clinical spectrum of HS-associated CHDs and reveals significant sex differences among patients with asplenia, unisplenia, and polysplenia. These findings may contribute to clinical classification, preoperative assessment, and individualized management strategies.

The Manipulated Genic Male Sterile Maintainer (MGM) system, a next-generation hybrid seed technology, enables efficient production of sortable seeds from genic male sterile (GMS) lines. However, implementing robust MGM systems in commercial maize inbred lines requires stable transformation, a genotype-specific and laborious process. This study aimed to integrate MGM technology into the commercial maize inbred line Z372, developing both GMS and MGM lines. We utilized the MGM line ZC01-3A-7, which contains the MS26ΔE5 editor T-DNA and MGM T-DNA, previously established in the highly transformable ZC01 recipient plants. Through a combination of crossing and backcrossing with Z372, we targeted the fertility gene Ms26 within the Z372 genome for mutation using the in vivo CRISPR/Cas9 activity within the MS26ΔE5 editor T-DNA construct. This approach facilitated precise editing of the Ms26 locus, minimizing linkage drag associated with the Ms26 mutation. Whole-genome SNP analysis achieved a 98.74% recovery rate for GMS and 96.32% for MGM in the BC2F2 generation. Importantly, the Z372-GMS line with the ms26ΔE5 mutation is non-transgenic, avoiding linkage drag and demonstrating production readiness. This study represents a significant advancement in maize breeding, enabling the rapid generation of GMS and MGM lines for efficient hybrid seed production.

Monascus pigments are the important natural additives in food industrial production. To obtain more economic pigments production processes, the present study was performed to evaluate the feasibility of using pomace resource as substrate for pigments production. Petri dish fermentation was designed to seek the optimal process parameters, and the value of red, yellow and total pigments per dry fermented substrate could achieve 654.6, 1268.1 and 1922.7 OD units/g, respectively. Shallow tray fermentation experiments were used for investigating the potential industrial production of pigments using potato pomace as sole carbon. The final total pigments of 200 g and 1000 g shallow tray experiments could reach 1886.9 and 1737.4 OD units/g. The results in this work indicating that potato pomace could be an efficient and low cost substrate for the production of Monascus pigments, and will supply a valuable reference for the comprehensive utilization of potato resources and seeking the economical natural pigments process.

The MYB transcription factors (TFs) are evolving as critical role in the regulation of the phenylpropanoid and tanshinones biosynthetic pathway. MYB TFs relate to a very important gene family, which are involved in the regulation of primary and secondary metabolisms, terpenoids, bioactive compounds, plant defense against various stresses and cell morphology. R2R3 MYB TFs contained a conserved N-terminal domain, but the domain at C-terminal sorts them different regarding their structures and functions. MYB TFs suppressors generally possess particular repressive motifs, such as pdLNLD/ELxiG/S and TLLLFR, which contribute to their suppression role through a diversity of complex regulatory mechanisms. A novel flower specific "NF/YWSV/MEDF/LW" conserved motif has a great potential to understand the mechanisms of flower development. In the current review, we summarize recent advanced progress of MYB TFs on transcription regulation, posttranscriptional, microRNA, conserved motif and propose directions to future prospective research. We further suggest there should be more focus on the investigation for the role of MYB TFs in microalgae, which has great potential for heterologous protein expression system for future perspectives.

Surgical treatment of complex coarctation is still a challenge. We performed extra-anatomic aortic bypass and Bentall procedure for a 10-year old boy diagnosed with critical aortic coarctation, aortic aneurysm, and severe aortic valve insufficiency who previously received Switch procedure. The patient is alive and well 52 months postoperatively with a satisfactory result. Extra-anatomic aortic bypass is a safe and effective procedure for patients with complex coarctation.

The goal of this study was to develop a submerged fermentation by Monascus purpureus for converting potato pomace, a low-cost byproduct generated in the potato starch industry, to a high value-added product containing soluble dietary fibers and Monascus pigments. Potato pomace was used directly without any pretreatments or hydrolysis in fermentation by M. purpureus to produce Monascus pigments, which was quantified by monitoring the absorbance of the fermentation broth at 492 nm wavelength and was found to reach a high level of 47.9 OD492/mL with a yield of 598.6 OD492/g pomace. Thermal stability analysis showed that the red pigments produced from potato pomace had a high activation energy of 71.6 kJ mol-1 at pH 5.0, indicating that the red pigment was thermally stable even at an acidic pH. Meanwhile, about 110.9 mg of soluble dietary fibers with porous microstructure, high solubility, and antioxidant activities were obtained from each gram of potato pomace after the fermentation. The results demonstrated the feasibility of converting potato pomace to a valuable product containing Monascus pigments and soluble dietary fibers by M. purpureus in submerged fermentation, providing an economical and environmentally friendly route for utilizing the agro-industrial waste byproduct.

Lecithin is a natural mixture of phospholipids and neutral lipids, and plays a vital role in the maintenance of cell-membrane integrity for all of the basic biological processes.This study aimed to evaluate the adhesion and growth of bone marrow-derived mesenchymal stem cells (BMSCs) on the three-dimensional (3D) electrospun lecithin-containing poly (L-lactic acid) (PLLA) fibrous scaffolds. In this study, PLLA and 0-15% of lecithin (wt.%) were dissolved in methylene chloride and thoroughly mixed to fabricate fibrous scaffolds by electrospinning technique. Surface morphology and hydrophilic properties of the scaffolds were characterized by scanning electron microscopy (SEM) and water uptake, respectively. The cytocompatibility of electrospun scaffolds and their potential cytotoxic effects on cells were studied over 8 days by seeding rat BMSCs on the scaffolds of PLLA containing 0-15% lecithin. Then cell proliferation was tested by CCK-8 assay and cell injury was assessed by measuring the release of intracellular lactate dehydrogenase (LDH). And cell morphology was studied by Toluidine blue staining, propidium iodide staining and SEM. The hydrophilicity was dramatically increased with an increase of lecithin content in the modified PLLA/lecithin scaffolds, as determined by rate of water uptake. In addition, the results obtained from in vitro assays suggested that the electrospun PLLA/5%lecithin scaffolds could possess the optimal hydrophilicity, higher adhesion and proliferation of BMSCs than PLLA, and they also did not lead to any significant toxic effects to cells. Moreover, BMSCs on PLLA/5%lecithin scaffolds tended to maintain their phenotypic shape and integrate with the microfibers to form a 3D cellular network, indicating a favorable interaction between this electrospun lecithin-based scaffolds and cells. The study demonstrated that the electrospun PLLA/lecithin fibrous scaffolds showed much better hydrophilicity and biocompatibility by introducing lecithin into the polymer in comparison with pure PLLA, which would offer a promising strategy for constructing tissue engnineered blood vessel.

目的:分析Ⅱ型合并室间隔缺损的肺动脉闭锁患者中固有肺动脉的发育情况及其影响因素.方法:回顾21例Ⅱ型合并室间隔缺损的肺动脉闭锁的影像学资料,分析体肺侧枝及固有肺动脉的形态学特点.结果:5例体肺侧枝直接与心包内固有肺动脉相连,不直接供应肺组织血供,肺动脉指数为1.5 ±0.3,固有肺动脉供应(15.2土3.2)个肺段.16例患者侧枝在肺叶及以下的肺动脉分支与固有肺动脉相连,肺动脉指数0.8±0.4,供应(4.9±4.7)个肺段,两组肺动脉发育及供应肺动脉范围差异有统计学意义.回归分析提示交通支直径是固有肺动脉发育的影响因子.结论:侧枝直接与心包内固有肺动脉相连,固有肺动脉发育好.侧枝在肺叶及以下的肺动脉分支与固有肺动脉相连,固有肺动脉发育差,且变异很大,固有肺动脉发育与交通支直径直接相关.

Background The yield of microalgae biomass is the key to affect the accumulation of fatty acids. A few microalgae can assimilate organic carbon to improve biomass yield. In mixotrophic cultivation, microalgae can use organic carbon source and light energy simultaneously. The preference of the main energy source by microalgae determines the biomass yield.Auxenochlorella protothecoidesis an oleaginous mixotrophic microalga that can efficiently assimilate glucose and accumulate a large amount of biomass and fatty acids. The current study focused on the effect of light on the growth and glucose assimilation ofA. protothecoides. Results In this study, we found that the uptake and metabolism of glucose inA. protothecoidescould be inhibited by light, resulting in a reduction of biomass growth and lipid accumulation. We employed comparative proteomics to study the influence of light on the regulation of glucose assimilation inA. protothecoides. Proteomics revealed that proteins involving in gene translation and photosynthesis system were up-regulated in the light, such as ribulose-phosphate 3-epimerase and phosphoribulokinase. Calvin cycle-related proteins were also up-regulated, suggesting that light may inhibit glucose metabolism by enhancing the production of glyceraldehyde-3-phosphate (G3P) in the Calvin cycle. In addition, the redox homeostasis-related proteins such as thioredoxin reductase were up-regulated in the light, indicating that light may regulate glucose uptake by changing the redox balance. Moreover, the increase of NADH levels and redox potential of the medium under illumination might inhibit the activity of the glucose transport system and subsequently reduce glucose uptake. Conclusions A theoretical model of how glucose assimilation inA. protothecoidesis negatively influenced by light was proposed, which will facilitate further studies on the complex mechanisms underlying the transition from autotrophy to heterotrophy for improving biomass accumulation.

Coronary artery aneurysm (CAA) has been increasingly reported in recent years. The symptoms are related to myocardial ischemia, such as angina pectoris, myocardial infarction, sudden death and congestive heart failure. This report describes a case of a giant CAA with calcification and stenosis involving two coronary arteries, and the patient underwent a complete arterialized coronary artery bypass graft successfully. In this report, all cases related to CAA with calcification and stenosis are summarized. According to the data, the following conclusions can be drawn: CAA seem to be more common in men; Kawasaki disease is likely to be a causative factor in some patients with asymptomatic CAA involving calcification and stenosis; CABG is a feasible treatment option for CAA with calcification and stenosis.

目的:总结肺动脉起源于动脉导管远端的先天性心脏病影像学特点并探讨其形成机制.方法:回顾16例符合肺动脉起源于动脉导管远端的先天性心脏病患者的影像学资料结合胚胎学理论,总结、分析其形态学特点.结果:一侧肺动脉起自主肺动脉,对侧肺动脉缺如5例;一侧肺动脉起自主肺动脉,对侧肺动脉起源于动脉导管远端2例;一侧肺动脉起源于动脉导管远端,对侧肺组织由粗大体肺侧枝供应2例;双侧肺动脉分别起源于同侧动脉导管远端5例;一侧肺动脉起源于动脉导管远端,对侧肺动脉缺如1例;一侧肺动脉起源于动脉导管远端,对侧肺动脉连接分流管道1例.结论:肺动脉起源于动脉导管的先天性心脏病的影像学表现多样,其病理解剖特点与第六对主动脉弓发育异常的范围、出生后导管是否闭合及合并畸形相关.

目的 总结我院用主动脉瓣成形术治疗儿童主动脉瓣疾病的方法和结果.方法 回顾性分析我院2005年1月至2017年12月30例行主动脉瓣成形术患儿的临床资料,其中男17例、女13例,年龄4个月～16岁,平均年龄(6.7±4.3)岁,体重5.6～62.4(23.7±14.1)kg.结果 30例患者均存活,围术期无严重并发症,术后平均跨瓣压差(21.1±17.0)mm Hg.随访9个月～l3年,共有4例患儿出现中度以上的主动脉瓣狭窄或关闭不全,其中1例行再次手术.其余患者瓣膜功能良好.结论 主动脉瓣成形术安全可靠,近中期效果良好,少数患者仍需再次手术,可作为治疗儿童主动脉瓣疾病的首选术式.

目的:二尖瓣血性囊肿是一种罕见的心内占位性病变,本文旨在总结二尖瓣血性囊肿的临床、病理学特点及手术治疗经验.方法:回顾分析2014年2月至2017年7月,清华大学第一附属医院收治4例二尖瓣血性囊肿患者的临床资料及随访结果.其中男性2例,女性2例;年龄7～63岁;合并心律失常(1例房性心动过速,1例室上性心动过速)2例,合并感染性心内膜炎1例,合并部分性心内膜垫缺损术后左心室流出道梗阻1例;患者术前经胸超声心动图发现血性囊肿附着于二尖瓣前叶(3例)或二尖瓣前叶腱索(1例)(直径范围9～ 30 mm),二尖瓣功能正常2例,二尖瓣中度狭窄并中度关闭不全1例,二尖瓣中度关闭不全1例.结果:4例患者术中均完整切除囊肿,并根据需要成形二尖瓣及腱索(2例).术后均恢复良好,术中食道超声及术后复查经胸超声心动图显示二尖瓣区未见囊肿,二尖瓣无狭窄或反流.术后随诊至今(1～4年),二尖瓣功能良好,未见囊肿复发,心律失常消失.结论:对于二尖瓣血性囊肿,超声心动图可明确诊断,手术治疗效果确切,预后良好.

目的:分析肺动脉闭锁(PA)患者中动脉导管未闭(PDA)的起源、形态及肺动脉发育情况.方法:回顾41例PA合并PDA患者的影像学资料结合胚胎学理论,分析PDA及肺动脉的形态学特点.结果:动脉导管连接肺动脉融合部35例,其中起源于主动脉弓降部32例,起源于锁骨下动无脉或无名动脉3例;双侧PDA例,导管分别起源于主动脉弓降部及无名动脉或锁骨下动脉根部,连接同侧肺门部肺动脉,无肺动脉融合部;动脉导管连接同侧肺门部肺动脉,另一侧肺由体肺侧枝供应肺血2例.结论:PA合并的PDA起源、形态及供血范围可出现较多变异;连接肺动脉融合部时动脉导管多合并不同程度的狭窄,连接一侧肺动脉时动脉导管多无明显狭窄甚至出现不同程度的脉动脉高压.

SCRaMbLE is a novel system implemented in the synthetic yeast genome, enabling massive chromosome rearrangements to produce strains with a large genotypic diversity upon induction. Here we describe a reporter of SCRaMbLEd cells using efficient selection, termed ReSCuES, based on a loxP-mediated switch of two auxotrophic markers. We show that all randomly isolated clones contained rearrangements within the synthetic chromosome, demonstrating high efficiency of selection. Using ReSCuES, we illustrate the ability of SCRaMbLE to generate strains with increased tolerance to several stress factors, such as ethanol, heat and acetic acid. Furthermore, by analyzing the tolerant strains, we are able to identify ACE2, a transcription factor required for septum destruction after cytokinesis, as a negative regulator of ethanol tolerance. Collectively, this work not only establishes a generic platform to rapidly identify strains of interest by SCRaMbLE, but also provides methods to dissect the underlying mechanisms of resistance.

The green alga Chlamydomonas reinhardtii was recently been shown to be an effective bio-manufacturing platform for the production of recombinant proteins. The advantage of using C. reinhardtii is that it is fast to grow, inexpensive to culture, and relatively safe. However, the expression of foreign proteins is always low and difficult to purify in C. reinhardtii. Human kallikrein has the potential to be developed into certain drugs, like insulin. Therefore, its biosynthesis is important to drug development. In this study, we synthesized the sg gene, a signal peptide sequence of alkaline phosphatase, and inserted it into a pH124 plasmid, which contains a HSP70A-RBCS2 promoter and a RBCS2 terminator. Then, we inserted the human kallikrein gene klk1 behind the sg sequence to make a pHsgk124 vector. The pHsgk124 were transferred into a cell-wall deficient strain of C. reinhardtii, cc-503, by using the glass bead method. Southern blot analysis showed that sg and klk1 were incorporated into genes of the transgenic C. reinhardtii. RT-PCR analysis showed that it had an active transcription and its expression increased three times under heat stress. Western blot analyses of proteins inside and outside cells (in the culture medium) showed that klk1 was expressed in the cell and the resulting protein was secreted into medium. An enzyme activity assay showed that the recombinant protein had the ability to hydrolyze the specific substrate H-D-Val-Leu-Arg-Pna. In conclusion, we successfully bioengineered C. reinhardtii to produce and secrete human kallikrein protein, which has important biomedical implications.

In order to enhance lutein accumulation and to explain the reasons for the difference in lutein accumulation under photoautotrophic and heterotrophic conditions, different culture modes and the associated transcriptome profiles were investigated in Auxenochlorella protothecoides. The heterotrophic-photoautotrophic transition culture mode was investigated for lutein accumulation, changing from organic carbon to increase biomass in dark fermentation to irradiation under nitrogen rich conditions. This strategy increased the lutein content 10 times along with chloroplast regeneration and little biomass loss in 48 h. The highest lutein productivity and production in the heterotrophic-photoautotrophic transition culture reached 12.36 mg/L/day and 34.13 mg/L respectively within seven days. Furthermore, compared to the photoautotrophic conditions, most genes involved in lutein biosynthesis and photosystem generation were down-regulated during heterotrophic growth. By contrast, two β-ring hydroxylases were transiently upregulated, while violaxanthin de-epoxidase and zeaxanthin epoxidase were mostly downregulated, which explained the extremely low lutein content of heterotrophic cells. Nevertheless, the lutein proportion in total carotenoids reached nearly 100%. This study is the first to our knowledge to report on a comparative transcriptome analysis of lutein biosynthesis, and it provides a promising strategy to boost lutein production in A. protothecoides.