Objective To evaluate the MRI findings and clinical features of methotrexate-induced acute encephalopathy in children.Methods The clinical data and brain MRI obtained in 13 children with methotrexate-induced acute encephalopathy were retrospectively reviewed.The MRI features were analyzed , including information on the location , the signal intensity and follow-up MRI study was performed.Results Of the 13 patients , 2 patients suffered from seizure.Five patients had dysphasia , of which 4 patients had evidence of hemiparesis , 1 patient had right facial palsy.Five patients had unilateral weakness.And left hemiparesis was observed in 1 patient.DWI revealed well demarcated asymmetrical hyperintensity lesions within the centrum semiovale and/or periventricular white matter in 10 patients, corresponding to areas of hypointensity on ADC maps.One case showed hyperintensity areas in the bilateral supratentorial cortex and subcortical white matter on T 2-weighted images with subtle high-intensity on DWI.In all 10 cases there were resolution of the diffusion abnormality , 8 cases displayed residual FLAIR signal abnormalities involving areas of previously seen diffusion restriction , 5 cases showed decreased range of the lesion , 1 case was progressive, and 2 cases were stable.One case with hyperintensity areas in the supratentorial cortex and subcortical white matter showed small residual hyperintensity on T 2-weighted images and resolution of the diffusion abnormality.Conclusions MTX-induced acute encephalopathy often manifests as stoke-like symptoms.DWI is the imaging modality of choice for the detection of acute MTX neurotoxicity , and asymmetrical restricted diffusion in the deep white matter is the characteristic sign.Cytotoxic edema induced by MTX is transient and reversible .

Objective To evaluate the role of Lactobacillus plantarum (LP) in the treatment of colitis in interleukin (IL)-10 knockout (IL-10-/-) mice and to explore its possible mechanisms.Methods Eight weeks old female wildtype (WT) mice and IL-10-/- mice, twenty mice of each type,were randomly assigned to four groups, WT group, WT+ LP group, IL-10-/- group and IL-I0-/- +LP group. The WT and IL-10-/- mice were gavaged with 0.5 ml saline, WT+Lp and IL-10-/- +Lp groups were gavaged with Lp 0.02 g (0.5 ml) ,took Lp 1 × 109 cfu everyday,continued for 4 weeks and then the experiment finished. The fresh mice faeces was collected once every week before (week 0) and during the experiment. The mice were executed at the end of experiments, the change of mice weight Was recorded, the length and the wet weight of colon were measured, fresh colon tissue specimens were taken for biological slices and proinflammatory cytokines TNF-a and IFN-γ were measured in colon mucosa. The fresh faeces were selectively cultured. The colonization of Lp in normal and colitis mice and its regulation role in intestinal flora were observed. Results Compared with WT mice, IL-10-/- mice demonstrated severe diarrhea, significantly decreased in body weight (P ＜0.05)and serious malnutrition. After Lp treatment, diarrhea relieved in IL-10-/- mice and the body weight increased significantly (P＜0.05). Pathological examination suggested that 100％ of IL-10-/-mice had intestinal inflammation, however after Lp treatment intestinal inflammation improved significantly. Mucosal ulcer, epithelial hyperplasia, the infiltration of neutrophils and lymphocytes in the lamina propria were also significantly reduced.The histopathological score was significantly lowered (P＜0.01). After Lp treatment, colon wet weight and the ratio of wet weight to length of IL-10-/- mice changed significantly (P＜0.01). Colon edema and thickening improved remarkably. The TNF-a and IFN-γ concentration of colon in IL-10-/- mice were 377.4±84.4 μg/g and 602.6±108.1 μg/g,which increased obviously than WT group (139.2 ± 32. 7 μg/g and 173.0± 52.4 μg/g, P＜0.05). After treated with Lp for four weeks, the TNF-α and IFN-γ concentration of colon in IL-10-/-+Lp group mice were 207.2±65.7 μg/g and 442.1 ± 138.4 μg/g, both were lower than that of IL-10-/- group mice (P＜0.05). The intestinal flora was disrupted in IL-10-/- mice. Conclusion Lp can effectively reduce intestinal inflammation in IL-10-/- mice, which take certain part in treatment in colitis. This treatment effect is associated with intestinal flora regulation and the inhibition of proinflammation cytokines expression.

Objective: To investigate the influences of enteral and parenteral nutrition suppled by gut on the gut microecology of the rats with abdominal infection. Methods: 14 Sprague-Dawley(SD)rats with abdominal infection models made with cecal ligation and perforation method were divided into two groups: parenteral nutrition (PN group, n=7) and PN+enteral nutrition (EN group, n=7) . The components of nutrition solutions in the two groups were isonitrogen and isocaloric. The rats were killed in the sixth day. The feces in cecum were cultured for anaerobic bacterial growth and analysed by bacterial group DNA fingerprint spectrum with random amplified polymorphic DNA . Results: ①The total death rate of the rats was 69.6%. Abdominal cavity abscess, liver abscess, and pulmonary infection commonly appeared in the model rats. ②The number of germs cultured in EN group was higher than in the PN group, but the quantity of Cl Perfrigens was higher , too. The gene stripe of probiotics group in EN group was similar to that in normal rats showed in the DNA fingerprint spectrum, but was significantly different in PN group with strange stripes. Conclusion: Application of early EN may correct the intestinal flora disturbance resulted from PN and increase the quantity of intestinal flora, but it can't control the species and may increase some conditional pathogenic bacteria .

Objective:To explore the clinical characteristics and to analyze the risk factors of recurrent acute pancreatitis (RAP).Methods:The clinical data of 3 022 patients with AP from AP database of the Affiliated Hospital of Southwest Medical University between January 2013 and December 2019 were retrospectively analyzed. According to with or without AP relapse and RAP diagnostic criteria, the patients were divided into initial group ( n=2 187) and recurrent group ( n=835). General characteristics, clinical data, and prognostic indicators were compared between the two groups. Multivariate logistic regression analysis was used to explore the risk factors of RAP. Results:The proportion of men, previous biliary disease, hyperlipidemia, diabetes mellitus and previous gallbladder or biliary surgery in recurrent group were significantly higher, while the mean age was significantly lower than that of the initial group. The main causes in the initial group successively were biliary disorders, hyperlipidemia and alcohol, while in the recurrent group were hyperlipidemia, biliary disorders and alcohol. The etiology of hyperlipidemia was significantly higher in the recurrent group than in initial group. The incidence of MAP and regional portal hypertension was significantly higher in the recurrent group, while the incidence of SAP and acute respiratory distress syndrome were significantly lower than those in the initial group, and all the differences were statistically significant(All P value <0.001). The results of the correlation analysis showed that there was no correlation between the severity of RAP and the number of recurrence, and the risk of SAP in RAP did not decrease with the increasing number of recurrence. The results of the multivariate logistic regression analysis showed that previous biliary disorders ( OR=1.303, 95% CI 1.032-1.645, P=0.026), previous history of hyperlipidemia ( OR=2.631, 95% CI 1.580-4.379, P<0.001), and the etiology of hyperlipidemia ( OR=1.773, 95% CI 1.465-2.145, P<0.001) were independent risk factors for RAP. Conclusions:RAP may often occur in middle-aged men and hyperlipidemia is the main cause of RAP, previous history of hyperlipidemia and biliary disease are risk factors for RAP.

Objective:To evaluate effectiveness of prevention and control strategies for COVID-19 in Ningbo by using an epidemic dynamic model.Methods:The incidence data and epidemic information of COVID-19 reported in Ningbo as of 9 March, 2020 were collected, and based on the implementation of prevention and control strategies, we developed a SEIR epidemic dynamics model. The basic and real-time reproduction numbers were calculated to evaluate effectiveness of prevention and control.Results:A total of 157 cases of COVID-19 were confirmed, without death, in Ningbo. The proportion of severe cases was 12.1 %. The mean incubation period was estimated to be (5.7±2.9) days. The mean interval from illness onset to diagnosis was (5.4±3.7) days. The mean duration from diagnosis to hospital discharge was (16.6±6.5) days. A total of 105 339 contacts had been under medical observation. The infection rates in contacts with home quarantine and centralized quarantine were 0.1 % and 0.3 %, respectively. In the confirmed cases, those who had been under medical observation before diagnoses accounted for 63.1 %. The basic reproduction number was estimated to be 4.8. With the strengthening of prevention and control measures, real-time reproduction number showed a gradual downward trend, dropping to below 1.0 on 4 February, and then continued to drop to 0.2 in mid-February. Conclusion:The effectiveness of the prevention and control measures for COVID-19 in Ningbo can be evaluated by using epidemic dynamic model to provide scientific evidence for the development of the prevention and control strategies.

Objective To compare the skin temperature around relevant and irrelevant meridian acu-points,or non-meridian sham acupoints in rats with myocardial ischemia by high frequency electro-acu-puncture(EA)at Neiguan(PC6)point or sham acupoint,in healthy rats and myocardial ischemic rats. Methods Fifty male Wister rats were randomly divided into five groups:blank control group,sham-op-eration group,model group,high frequency EA at Neiguan group(PC6)and high frequency electro-acu-puncture at sham acupoint groups.Rats in high frequency EA at and at sham acupoints group received EA intervention after their models were successfully established.Temperature around the skin of Neiguan (PC6),Yanglingquan(GB34)and sham acupoints were measured and recorded by infrared thermogra-phy in every group at 30 minutes 60 minutes after three-day treatment for statistical analysis.Results Compared with the blank control group,skin temperature around PC6 in model groups was significantly lower(P<0.01);Compared with the model group,skin temperature around PC6 in high frequency EA at PC6 group was significantly increased(P <0.01);Skin temperature around PC6, GB34 and sham acupoint in high frequency EA at sham acupoint groups presented with no statistical significance; skin temperature around PC6 in high frequency EA at PC6 group was similar to the skin temperature of blank control group,which was measured 30 minutes after the treatment.Conclusion The relative specificity of skin temperature around PC6 can be useful for the reflection of different conditions of rats' myocardi-um.High-frequency electro-acupuncture at PC6 can prevent the reduction of skin temperature caused by myocardial ischemia injury,of which the mechanism needs further study.

Objective:To study the changes of early (i.e., within post injury day (PID) 14) coagulation function in patients with severe burns.Methods:A retrospective case series study was conducted. From December 2018 to December 2019, 50 severe burn patients who met the inclusion criteria were admitted to Guangzhou Red Cross Hospital of Jinan University. According to the severity of burns, the patients were divided into severe burn group (17 cases, including 12 males and 5 females) and extremely severe burn group (33 cases, including 26 males and 7 females). The platelet count (PLT), and conventional coagulation indexe and thromboelastogram index levels of patients were collected at admission, post injury hour (PIH) 48 and 72, and on PID 7 and 14. The conventional coagulation indexes included prothrombin time (PT), thrombin time (TT), activated partial prothrombin time (APTT), and fibrinogen (FIB) and D-dimer levels. The thromboelastogram indexes included coagulation angle (i.e., α angle), coagulation composite index (CI), MA value, R value, and K value (reflecting maximum amplitude, coagulation reaction time, and blood agglutination time, respectively). Data were statistically analyzed with independent sample t-test, Wilcoxon rank sum test, and chi-square test. Verification of the mixed effect model was performed on each index data of patients in the two groups, while the repeated measures analysis of variance was performed on PLT. Pearson correlation analysis or Spearman correlation analysis were performed to analyze the correlation between the thromboelastogram index data (except CI) and the PLT and conventional coagulation index data, respectively. Results:At admission, PIH 48 and 72, and on PID 7 and 14, PLT of patients in severe burn group were (203±91), (148±70), (123±63), (203±62), (402±140)×10 9/L, respectively, PLT of patients in extremely severe burn group were (235±116), (145±71), (109±52), (235±106), (455±138)×10 9/L, respectively. In overall comparison, only the difference of the main effect of time factor was statistically significant ( F=92.55, P<0.05). In severe burn group, statistically significant differences were only identified in comparison of patients' PLT between PID 7 and the adjacent two time points (at PIH 72 and on PID 14, with both P values <0.05). The differences in PLT of patients between all the adjacent time points in extremely severe burn group were statistically significant ( P<0.05). In the overall comparison of PT, TT, and FIB level of patients in the two groups at each time point, only the difference of main effect of time factor was statistically significant (with F values of 6.04, 8.45, and 32.90, respectively, all P values <0.05), and APTT and FIB level of patients in extremely severe burn group within PID 14 were higher than those in severe burn group. There were statistically significant differences in MA value, α angle, K value, and CI of patients in the two groups at each time point (with F values of 18.82, 11.38, 9.11, and 9.42, respectively, all P values <0.05). MA value was moderately correlated with PLT ( r=0.69, P<0.05), weakly correlated with TT and FIB level (with r values of -0.29 and 0.30 respectively, P<0.05), and very weakly correlated with D-dimer level ( r=-0.15, P<0.05); α angle was moderately correlated with PLT ( r=0.58, P<0.05), and weakly correlated with FIB level and TT (with r values of 0.26 and -0.29, respectively, P<0.05); R value was weakly correlated with APTT and FIB level (with r values of 0.24 and 0.31, respectively, P<0.05), and very weakly correlated with PT and TT (with r values of 0.16 and 0.14, respectively, P<0.05); K value was moderately correlated with PLT ( r=-0.59, P<0.05), and weakly correlated with FIB and TT (with r values of -0.29 and 0.32, respectively, P<0.05), and very weakly correlated with D-dimer level ( r=-0.15, P<0.05). Conclusions:Severe burn patients are already characterized with coagulation function changes in early stage, including insufficiency of coagulation function, enhanced platelet aggregation ability and enhanced FIB function. There is a certain correlation between conventional coagulation indexes and thromboelastogram indexes, but they cannot replace each other.

The diagnosis of sleep apnea syndrome (SAS) has a significant importance in clinic for preventing diseases of hypertention, coronary heart disease, arrhythmia and cerebrovascular disorder, etc. This study presents a novel method for SAS detection based on single-channel electrocardiogram (ECG) signal. The method preprocessed ECG and detected QRS waves to get RR signal and ECG-derived respiratory (EDR) signal. Then 40 time- and spectral-domain features were extracted to normalize the signals. After that support vector machine (SVM) was used to classify the signals as "apnea" or "normal". Finally, the performance of the method was evaluated by the MIT-BIH Apnea-ECG database, and an accuracy of 95% in train sets and an accuracy of 88% in test sets were achieved.
Algorithms ; Electrocardiography ; methods ; Humans ; Signal Processing, Computer-Assisted ; Sleep Apnea Syndromes ; diagnosis ; Support Vector Machine

Objective: To understand the relations between high risk sexual behavior and HIV infection among MSM in ways of finding male partners in Ningbo. Methods: A cross-sectional study was conducted in Ningbo between April and November in 2018. Data related to socio-demographics, ways of finding male partners, adoption of gay apps and sexual behaviors were collected by snowball method. Blood samples were drawn for HIV antibody testing. Classified data was evaluated by chi-square test. Related factors on HIV infection were analyzed by multivariate logistic regression. Results: A total of 735 participants were included in this study. Ways of finding male partners would through gay apps (60.8%, 447/735), QQ/Wechat (32.3%, 237/735) and gay-places (6.9%, 51/735). Related information on high risk sexual behavior and HIV infection among gay apps users were found as: 16.8%(75) had sexual behavior once per week in the past 6 months, 41.8% (187/447) had multiple sexual partners, 12.1% (54/447) had unprotected anal intercourse in the last time, 52.3% (234/447) having had unprotected anal intercourse in the past 6 months. The overall HIV prevalence rate was 12.1%(54/447). Among the HIV cases who got infected within the two years, 68.6%(24/35) of them had used gay apps for less than two years. Results from the, multivariate logistic regression analysis showed that gay apps users were more susceptible to infected HIV than those who used the QQ/Wechat (OR=3.03, 95%CI: 1.30-7.07). Conclusions Gay apps was popularly known among the Ningbo MSM, and was associated with the high risk sexual behaviors and HIV infection. HIV control and prevention programs should be strengthened in the MSM population who used the gay apps. Related surveillance and intervention programs for MSM, who use the gay apps, need to be further reinforced.