PurposeStruma ovarii (SO) is rare and has no typical symptoms, which is likely to be misdiagnosed before procure. The present study aimed to evaluate multi-sliced CT (MSCT) findings of struma ovarii so as to improve its imaging diagnosis.Materials and Methods The clinical and radiological data of 25 patients with struma ovarii confirmed pathologically patients were retrospectively analyzed and further compared with the pathological results after procure.Results For 25 SO patients, 22 (88%) had unilateral lesions and the rest 3 (12%) had bilateral ones; 11 lesions (44%) were cystic, 8 lesions (32%) were cystic-solid, and 6 lesions (24%) were solid. The CT images of 8 lesions showed high density cystic lumens. Twenty-five tumors had smooth margins, which appeared round, ellipse or irregular. The pathological findings showed that most of the cystic portions were filled with high proteinaceous gelatinous fluid and eosinophiclic colloid, and the solid portions consisted of thyroid tissue and stoma containing abundant blood vessels and fibrous tissue.Conclusion SO has the MSCT features such as cystic solid mass with unilateral and smooth margin, capsular space with high density, calcification, and solid parts with obvious enhancement.

OBJECTIVE:To observe the effect of pathological lesion of renal tissue in rats with spontaneous hypertension (SHR),and study its mechanisms based on nuclear factorκB(NF-κB)signaling pathway. METHODS:21 SHR were randomly di-vided into model group and ICA low-dose,high-dose groups(20,40 mg/kg,denoted by ICA-L,ICA-H groups);other 7 homolo-gous Kyoto rats (WKY) were regarded as control group. All rats were intragastrically administrated,twice a day,for 11 weeks, rats in control group and model group received equal volume of double distilled water,ig. Pathological changes in renal tissue in each group were observed;Western blot method was used to detect protein expressions of p-NF-κB-p65,IκB and TNF-α in renal tissue. RESULTS:Compared with control group,model group showed disorder renal structure,narrow and irregular glomerular cysts;the protein expression of IκB was significantly down-regulated,protein expressions of p-NF-κB-p65 and TNF-α were signifi-cantly up-regulated(P<0.01). Compared with model group,the above-mentioned changes of rats showed improvement in ICA-L, ICA-H groups;the protein expression of IκB was significantly up-regulated in ICA-L,ICA-H groups (P<0.05 or P<0.01);the protein expressions of p-NF-κB-p65 and TNF-α were significantly down-regulated(P<0.01)in ICA-H groups;p-NF-κB-p65 pro-tein expression was significantly down-regulated in ICA-L group(P<0.05);while there was no significant difference in TNF-αpro-tein expression in ICA-L group(P>0.05). CONCLUSIONS:ICA plays a role in improving renal pathological lesion in SHR,and the mechanism may be related to inhibiting NF-κB signaling pathway.

Objective To investigate the association of monocyte chemoattractant protein-1 (MCP-1) promoter -2518A/G gene polymorphism with coronary lesions and in stent restenosis in Tianjin Chinese population. Methods Two hundred and seventy six patients who underwent percutaneous coronary intervention (PCI) and coronary angiography during follow-up were enrolled in the study. The MCP-1 gene promoter polymorphism at position -2518 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results The frequencies of three genotypes of MCP-1-2518A/G polymorphism were 21.0% AA, 34. 1% GG,44.9% AG, respectively. There were no statistical differences in the number and the mean degree of stenosis vessels before PCI among 3 genotype groups (all P＞0.05). 113 cases developed in-stent restenosis and 163 cases were free from restenosis. In restenosis group, the AA, AG and GG genotype frequencies were 23.9%, 40.7%, 35.4%, against 19.0%, 47.9% and 33.1% in nonrestenosis group (P = 0. 446) . The frequencies of -2518A and G allele were 44.2%, 55.8% in restenosis group versus 42.9%, 57. 1% in non-restenosis group(P=0. 761). Conclusions The polymorphism of MCP-1-2518 A/G gene may be associated with neither atherosclerosis nor the in-stent restenosis.

Objective:To study factors associated with postoperative acute pancreatitis (POAP) in patients following pancreaticoduodenectomy.Methods:This retrospective analysis included 60 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Soochow University from Jan 2020 to Aug 2021. Enhanced computed tomography was used to identify POAP during postoperative period of 4 to 9 days. Univariate analysis and multivariate analysis were used to find out the risk factors of POAP.Results:Of the 60 patients, 13 cases (21.7%) developed POAP. The incidence of clinically related pancreatic fistula with abdominal abscess (76.9% vs.19.1%, χ2=15.71, P<0.000 1), postoperative hospital stay (26 d vs. 18 d, U=141.5, P=0.002 5) and the severity of complications (Clavien-Dindo grade≥Ⅲ: 53.8% vs. 21.3%, χ2=5.32, P=0.02) were significantly higher in the POAP group. But there was no significant deviation between the two groups when it comes to the severe post pancreatectomy delayed hemorrhage (7.7% vs. 0, χ2=3.68, P=0.06) and the delayed gastric emptying (30.8% vs. 21.3%, χ2=0.51, P=0.47). In the univariate analysis, patients with higher body mass index ( P=0.000 3), smaller main pancreatic duct diameter ( P<0.000 1) and softer texture of the pancreas ( P=0.009) were more likely to develop POAP after pancreaticoduodenectomy. In the multivariate analysis, the pancreatic duct diameter≤2 mm ( OR=0.005,95% CI 0.000 06-0.44, P=0.020), the softer texture of pancreas ( OR=0.005, 95% CI 0.000 04-0.47, P=0.023) were risk factors for POAP. Conclusions:Patients with postoperative acute pancreatitis increased the incidence of pancreatic fistula complicating abdominal abscess.Small caliber pancreatic tube, soft texture of pancreas were risk factors of POAP.

Objective:To explore mechanical stability of Proximal Humeral Internal Locking Plate System (PHILOS) in the treatment of Vancouver B1 femoral periprosthetic fractures by three-dimensional finite element analysis.Methods:A three-dimensional finite element model of the femur was established by digital medical software (Mimics 21.0, 3-matic12.0, Geomagic12.0 and Hypermesh 2017.0) using the CT data of a femur from a volunteer (male, 34 years old, 173 cm in height and 65 kg in weight). After the femoral trochanter was cut in the femoral models, a femoral stem was implanted. PHILOS fixation (PHILOS group) and Cable-Ready GTR fixation (Cable group) were applied respectively. Loads of 700 N, 1,400 N and 2,100 N were applied to the 2 groups of finite element models. Distributions of Von Mises stress and deformation were investigated in the finite element models of 2 internal fixations; the mechanical stability was compared between the 2 groups of models.Results:The maximum deformation occurred on the femoral ball head in the 2 groups of models. At the load of 2,100 N, the maximum deformation was 3.77 mm in the PHILOS group, larger than 3.58 mm in the Cable group, and the maximum stress peak value in the PHILOS group was 491.54 MPa, about 49.2% lower than that in the Cable group (733.61 MPa). The peak stress in the PHILOS group was mainly distributed on the 4th and 5th fixation ends at the bone plate while the peak stress in the Cable group was mainly distributed on the second titanium cable under the fracture line.Conclusions:Under various loads, both PHILOS fixation and Cable-Ready GTR fixation can provide sufficient mechanical stability. As the peak stress of PHILOS fixation is much lower than that of Cable-Ready GTR fixation, PHILOS can be used as an effective fixation method for Vancouver B1 femoral periprosthetic fractures.

To report a case of Noonan-like syndrome with loose anagen hair, and to detect gene mutations in the family. A 3-year-old female patient presented with a special facial appearance, short stature, deep palmar and plantar creases, and dark skin. The scalp hair was sparse and thin, dermoscopy showed black spot sign, single-hair follicular units, hair shafts varying in the diameter, upright hair and new vellus hair, and constriction of hair shafts and nodular hair were occasionally observed. Peripheral blood samples were collected from the proband and her parents, and the genomic DNA was extracted for whole-exome sequencing. A heterozygous missense mutation c.4A>G was identified in exon 2 of the SHOC2 gene in the proband, resulting in the substitution of serine by glycine at amino acid position 2 (p.S2G) . The mutation was not identified in either of her parents. Combined with the clinical phenotype and gene mutation, the diagnosis of Noonan-like syndrome with loose anagen hair was confirmed.

Objective To evaluate the value of rs61330082 and rs4730153 polymorphisms of Visfatin locus for the diagnosis of type 2 diabetes mellitus(T2DM)in a high-risk population.Methods SNPscanTM high-throughput single nucleotide polymorphism typing technique was used to genotype Visfatin gene loci rs61330082 and rs4730153 in 346 T2DM patients(T2DM group)and 1426 normal controls(NC group).Logistic regression analysis was used to analyze T2DM risk factors.ROC curves were used to analyze the optimal cut-off values of Visfatin gene rs61330082 and rs4730153 for the diagnosis of T2DM.Results The proportion of women,age,obesity,smoking,hypertension,FPG,HbA1c and TG were higher in T2DM group than those in NC group(P<0.01)and HDL-C was lower than in NC group(P<0.01).The frequency of G allele and GG genotype was higher in T2DM group compared with NC group(P<0.05).Logistic regression analysis showed that age,female,obesity,hypertension,TG,and GG genotype at rs4730153 locus were risk factors for T2DM,HDL-C was a protective factor for T2DM.The area under the ROC curve of GG genotype at Visfatin rs4730153 mutation for diagnosis of T2DM was 0.668 and the optimal cut-off point for predicting T2DM was 20.04%,with sensitivity 60.1%and specificity 66.1%,respectively.Conclusion The GG genotype of Visfatin gene rs4730153 locus is associated with the risk of T2DM and can beused as a candidate gene for predicting phenotype of T2DM.

Objective To design a multisensory supported device and evaluate its effectiveness on preterm infants(born before 34 weeks)during NICU hospitalization.Methods The multisensory supported device is composed of a basement,several soft cushions and an adjustable eye mask.The inner layer of the device comprises of the head and tail boundaries,serves as uterine wall-like circular boundaries.The outer skeleton is equipped with multisensory stimulation modules to provide visual,hearing,and tactile sensory stimulations for premature infants.The study was conducted in a NICU of a tertiary A children specialist hospital in Shanghai,China.The convenience sampling method was used and based on the ratio of 1∶2 between the experimental and the control group in this study.The control group was treated by standard nursing care,while the experiment group was treated with the multisensory supported device in addition to NICU conventional care.All infants were assessed during the week of admission and again at corrected gestational age of 36 weeks.The actigraphy watch which was used for 72 hours continuous record of the activities of study infants,allows the researcher to compare the activity scores,wakefulness and sleep indicators of 2 groups of infants.Results 71 preterm infants were enrolled in the study,and 60 preterm infants completed data collection for study data analysis,including 20 in the experimental group and 40 in the control group.There were no statistical differences in demographic characteristics and clinical status regarding wakefulness,sleep and physical development between the 2 groups in baseline(P＞0.05).At 36 weeks of corrected gestational age,the activity score of the experimental group was(46.61±12.14)points,and that of the control group was(57.33±18.36)points,with statistically significant differences in 2 groups(P=0.024).The total waking time of the experimental group was(384.85±169.42)min,and that of the control group was(492.08±220.45)min,with statistically significant differences in 2 groups(P=0.049).There was no statistical difference in other indicators between 2 groups(P＞0.05).Conclusion The multisensory supported device can reduce high-frequency unpleasant activity as well as frequent wakefulness status,which could promote the sleeping quality of preterm infants.Further studies are needed to verify further effects of the device on premature infants'physical development.

Objective:To investigate respiratory virus infection in children with septic shock in pediatric care units (PICU) in China and its influence on clinical outcomes.Methods:The clinical data of children with septic shock in children′s PICU from January 2018 to December 2019 in 10 Chinese hospitals were retrospectively collected. They were divided into the pre-COVID-19 and post-COVID-19 groups according to the onset of disease, and the characteristics and composition of respiratory virus in the 2 groups were compared. Matching age, malignant underlying diseases, bacteria, fungi and other viruses, a new database was generated using 1∶1 propensity score matching method. The children were divided into the respiratory virus group and non-respiratory virus group according to the presence or absence of respiratory virus infection; their clinical characteristics, diagnosis, and treatment were compared by t-test, rank sum test and Chi-square test. The correlation between respiratory virus infection and the clinical outcomes was analyzed by logistic regression. Results:A total of 1 247 children with septic shock were included in the study, of them 748 were male; the age was 37 (11, 105) months. In the pre-and post-COVID-19 groups, there were 530 and 717 cases of septic shock, respectively; the positive rate of respiratory virus was 14.9% (79 cases) and 9.8% (70 cases); the seasonal distribution of septic shock was 28.9% (153/530) and 25.9% (185/717) in autumn, and 30.3% (161/530) and 28.3% (203/717) in winter, respectively, and the corresponding positive rates of respiratory viruses were 19.6% (30/153) and 15.7% (29/185) in autumn, and 21.1% (34/161) and 15.3% (31/203) in winter, respectively. The positive rates of influenza virus and adenovirus in the post-COVID-19 group were lower than those in the pre-COVID-19 group (2.1% (15/717) vs. 7.5% (40/530), and 0.7% (5/717) vs. 3.2% (17/530), χ2=21.51 and 11.08, respectively; all P<0.05). Rhinovirus virus were higher than those in the pre-Covid-19 group (1.7% (12/717) vs. 0.2% (1/530), χ2=6.51, P=0.011). After propensity score matching, there were 147 cases in both the respiratory virus group and the non-respiratory virus group. Rate of respiratory failure, acute respiratory distress, rate of disseminated coagulation dysfunction, and immunoglobulin usage of the respiratory virus group were higher than those of non-respiratory virus group (77.6% (114/147) vs. 59.2% (87/147), 17.7% (26/147) vs. 4.1% (6/147), 15.6% (25/147) vs. 4.1% (7/147), and 35.4% (52/147) vs. 21.4% (32/147); χ2=11.07, 14.02, 11.06 and 6.67, all P<0.05); and PICU hospitalization of the former was longer than that of the later (7 (3, 16) vs. 3 (1, 7)d, Z=5.01, P<0.001). Univariate logistic regression analysis showed that the presence of respiratory viral infection was associated with respiratory failure, disseminated coagulation dysfunction, the use of mechanical ventilation, and the use of immunoglobulin and anti-respiratory viral drugs ( OR=2.42, 0.22, 0.25, 0.56 and 1.12, all P<0.05). Conclusions:The composition of respiratory virus infection in children with septic shock is different between pre and post-COVID-19. Respiratory viral infection is associated with organ dysfunction in children with septic shock. Decreasing respiratory viral infection through respiratory protection may improve the clinical outcome of these children.

Objective:To investigate the clinical features, pathogen composition, and prognosis of septic shock in pediatric intensive care units (PICU) in China.Methods:A multicenter retrospective cohort study. A retrospective analysis was conducted on the clinical data of children with septic shock from 10 hospitals in China between January 2018 and December 2021. The clinical features, pathogen composition, and outcomes were collected. Patients were categorized into malignant tumor and non-malignant tumor groups, as well as survival and mortality groups. T test, Mann Whitney U test or Chi square test were used respectively for comparing clinical characteristics and prognosis between 2 groups. Multiple Logistic regression was used to identify risk factors for mortality. Results:A total of 1 247 children with septic shock were included, with 748 males (59.9%) and the age of 3.1 (0.9, 8.8) years. The in-patient mortality rate was 23.2% (289 cases). The overall pathogen positive rate was 68.2% (851 cases), with 1 229 pathogens identified. Bacterial accounted for 61.4% (754 strains) and virus for 24.8% (305 strains). Among all bacterium, Gram negative bacteria constituted 64.2% (484 strains), with Pseudomonas aeruginosa and Enterobacter being the most common; Gram positive bacteria comprised 35.8% (270 strains), primarily Streptococcus and Staphylococcus species. Influenza virus (86 strains (28.2%)), Epstein-Barr virus (53 strains (17.4%)), and respiratory syncytial virus (46 strains (17.1%)) were the top three viruses. Children with malignant tumors were older and had higher pediatric risk of mortality (PRISM) Ⅲ score, paediatric sequential organ failure assessment (pSOFA) score (7.9 (4.3, 11.8) vs. 2.3 (0.8, 7.5) years old, 22 (16, 26) vs. 16 (10, 24) points, 10 (5, 14) vs. 8 (4, 12) points, Z=11.32, 0.87, 4.00, all P<0.05), and higher pathogen positive rate, and in-hospital mortality (77.7% (240/309) vs. 65.1% (611/938), 29.7% (92/309) vs. 21.0% (197/938), χ2=16.84, 10.04, both P<0.05) compared to the non-tumor group. In the death group, the score of PRISM Ⅲ, pSOFA (16 (22, 29) vs. 14 (10, 20) points, 8 (12, 15) vs. 6 (3, 9) points, Z=4.92, 11.88, both P<0.05) were all higher, and presence of neoplastic disease, positive rate of pathogen and proportion of invasive mechanical ventilation in death group were also all higher than those in survival group (29.7% (87/289) vs. 23.2% (222/958), 77.8% (225/289) vs. 65.4% (626/958), 73.7% (213/289) vs. 50.6% (485/958), χ2=5.72, 16.03, 49.98, all P<0.05). Multiple Logistic regression showed that PRISM Ⅲ, pSOFA, and malignant tumor were the independent risk factors for mortality ( OR=1.04, 1.09, 0.67, 95% CI 1.01-1.05, 1.04-1.12, 0.47-0.94, all P<0.05). Conclusions:Bacterial infection are predominant in pediatric septic shock, but viral infection are also significant. Children with malignancies are more severe and resource consumptive. The overall mortality rate for pediatric septic shock remains high, and mortality are associated with malignant tumor, PRISM Ⅲ and pSOFA scores.