Objective To analyze the clinical features,curative effect and prognosis of extra-pulmonary infections by mycoplasma pneumoniae(MP).Methods ELISA was used to detect anti-MP IgM and IgG.Case histories of 226 patients,whose nasopharyneal lotione and respiratory secretions were positive of virus and bacteria respectively,was analysed retrospectively.Results One hundred and eighteen of the 226 (52.2%) cases suffered from extra-pulmonary infection.Of these infections 38.98%,33.89%,21.11% and 17.79% were found in digestive, urinary, cardiovascular systems and serous membrane respectively.All of the cases were improved after treatment with macrolides antibiotics.All cases were MP IgM positive,35.5% cases were IgG positive.Spatum MP positive rate was 32.2%.Positive rate of cold-agglutination test was 47.46%.Conclusions MP infection may cause many extra-pulmonary complications.When multi-organ infections can not be explained with bacterial and viral infections,MP infection should be considered.

Objective:To investigate the related factors affecting intraoperative blood loss in patients with spinal tumors undergoing preoperative selective arterial embolization.Methods:The clinical data of 90 patients with spinal tumors who underwent preoperative selective arterial embolization in the Affiliated Hospital of Jining Medical College and the Second Affiliated Hospital of Shanxi Medical University from January 2017 to December 2020 were retrospectively analyzed. The influencing factors of intraoperative bleeding were analyzed by using multiple linear regression.Results:There were statistically significant differences in intraoperative blood loss of spinal tumor patients undergoing preoperative selective arterial embolization with different blood supply abundance and the number of tumors involving vertebral body (all P < 0.05). There were no significant differences in age, gender, body mass index, interval after embolization, operation time, pathological type, tumor site, embolization degree, the number of embolized vessels, preoperative Frankel grade among different groups (all P > 0.05). Multiple linear regression analysis showed that the number of tumors involving vertebral body and tumor blood supply abundance were factors affecting intraoperative blood loss, and vertebra number and tumor blood supply were positively correlated with intraoperative blood loss (all P < 0.05). Conclusion:For patients with spinal tumors undergoing preoperative selective arterial embolization, the number of tumors involving vertebral body and the abundance of the tumor blood supply are factors affecting the amount of intraoperative bleeding.

OBJECTIVETo compare and analyze the MRI features of different renal cell carcinoma (RCC) subtypes.

METHODSThe MR images of 81 surgically and pathologically confirmed renal cell carcinomas from 79 patients were reviewed retrospectively. The MR imaging features of lesions in plain scan, the degree and patterns of lesion enhancement (homogeneous, heterogeneous, peripheral), and tumor spreading patterns were analyzed. In order to evaluate the diagnostic validity of differentiating RCC subtypes using signal enhancement, receiver operating characteristic curves (ROC) were generated. The cutoff value of post-contrast signal intensity to noise ratios (SNR) of the tumor parenchyma were also generated in order to differentiate clear cell RCC from other subtypes.

RESULTSOf the 81 lesions, 58 were clear cell carcinomas, 10 chromophobe cell carcinomas, 8 papillary cell carcinomas, and 5 unclassified RCC. All the chromophobe cell subtype tumors showed a homogeneous density (P < 0.05). The clear cell subtype tumors were likely heterogenous, and also showed heterogenous enhancement with mixed signal than other subtypes (P < 0.05). The cutoff value of SNR, which was used to differentiate clear cell subtype from the other subtypes, were 616 (corticomedullary phase), 579 (nephrographic phase) and 278 (excretory phase), retrospectively. The nephrographic phase is the most appropriate for differentiation, with a sensitivity of 62.1%, specificity of 91.3%, positive predictive value of 94.7%, negative predictive value of 48.8% and an accuracy value of 70.3%. No significant difference was found in tumor spreading patterns among all subtypes of RCC.

CONCLUSIONMR imaging features, particularly tumor heterogeneity and degree of enhancement are useful in differentiation of the renal cell carcinoma subtypes, and in choosing an individualized therapy.

Adult ; Aged ; Carcinoma, Renal Cell ; pathology ; Female ; Humans ; Image Enhancement ; methods ; Kidney Neoplasms ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Young Adult

OBJECTIVETo improve clinicians' ability of diagnosing testicular torsion.

METHODSWe reviewed the data of a case of testicular torsion that resulted in necrosis because of delayed presentation and repeated misdiagnosis, and analyzed its anatomic features, clinical manifestations, ultrasound results, the causes of misdiagnosis and relevant literature.

RESULTSThe patient presented 5 hours after the onset of symptoms, complaining of severe paroxysmal pain in the lower left abdomen, accompanied with nausea and vomiting, and was twice misdiagnosed as having enterospasm or ureteral calculus at two different hospitals. Fifteen hours later, surgical exploration revealed an about 900-degree testicular torsion in the spermatic cord, which necessitated orchiectomy for non viability of the testis. Postoperative pathological examination confirmed testicular necrosis and diffused hemorrhage in the testis and epididymis.

CONCLUSIONTimely presentation, correct diagnosis and proper treatment are keys to saving the affected testis. Color Doppler ultrasound is an ideal option for the definite diagnosis of acute scrotal diseases, and it offers a valuable guidance for related surgery as well.

Adult ; Diagnostic Errors ; Humans ; Male ; Necrosis ; Spermatic Cord Torsion ; diagnosis ; Testis ; pathology

OBJECTIVETo investigate the histological components and solubility of the bile-cast, and to study the pathological course of bile cast formation.

METHODSHE staining, bilirubin staining (Gmelin reaction), Masson's staining, alcian blue staining and fibrin staining (weigert's) were performed on the formalin-fixed paraffin-embedded section of the bile cast. Ultrastructure was examined under the scanning electron microscope. Solubility test was also conducted using chymotrypsin, heparin, trypsin solution, HCl and NaOH solution to dissolve the bile-cast.

RESULTSThe major components of the bile-cast were bilirubin crystals and collagen fibers. Between the mass of collagen fibers there was certain blood vessel structure. Necrosis bile duct structure was not found in the cast. Under the scanning electron microscope, four kinds of crystal morphologies were viewed. There were some mucoid mass and necrosis defluvium epithelial cells in the bile cast. Solubility test showed that the bile cast could be partial dissolved in NaOH solution (pH = 12.5). No dissolution was found in HCl solution (pH = 5.0), chymotrypsin solution, heparin and trypsin solution.

CONCLUSIONSCollagen fibers work as framework in the bile cast with bilirubin crystal filling between the framework. The emergence of fibroblast and blood vessels indicated the formation of bile cast might be the course of exudation and organization due to bile duct epithelium damage. Bile cast could be partially dissolved in alkaline solution, but could not be dissolved in acid solution, or in chymotrypsin, heparin and trypsin solutions.

Bile Duct Diseases ; etiology ; pathology ; Bile Ducts ; ultrastructure ; Humans ; Immunohistochemistry ; Liver Transplantation ; adverse effects ; Microscopy ; Postoperative Complications ; Staining and Labeling

OBJECTIVETo construct prokaryotic expression vector of pET15b-PEP-1-SOD1 and investigate whether PEP-1-SOD1 fusion protein could be transduced into human umbilical vein endothelial cells (HUVECs) and the effects on hypoxia/reoxygenation injury.

METHODSThe recombinant plasmids pET15b-SOD1 and pET15b-PEP-1-SOD1 were constructed and transformed into E. coli BL21 (DE3) to express SOD1 and PEP-1-SOD1 with an N-terminal His-tag. The purified SOD1 and PEP-1-SOD1 were incubated with HUVECs and the viability (MTT assay) and the release of lactate dehydrogenase (LDH) in culture medium were determined in the hypoxia/reoxygenation injury model. The morphological changes were observed under an inverted phase contrast microscope. The content of malondialdehyde (MDA) in HUVECs was also determined with the method of thiobarbituric acid.

RESULTSPEP-1-SOD1 fusion protein could be transduced into cultured HUVECs in a time- and dose-dependent manner. The intracellular enzymatic activity of PEP-1-SOD1 after 30 min incubation with HUVECs was significantly higher than control group (60.88 U/ml +/- 6.73 U/ml vs. 41.06 U/ml +/- 4.19 U/ml, P < 0.01). The transduced PEP-1-SOD1 protein was enzymatically stable for 24 h within cells. After hypoxia/reoxygenation injury, control HUVECs shrunk, became round-shaped and intercellular space increased, while these morphological changes were not observed in PEP-1-SOD1 transduced HUVECs. PEP-1-SOD1 transduction also markedly increased the viability, decreased LDH leakage into culture media and reduced the content of MDA post hypoxia/reoxygenation.

CONCLUSIONSPEP-1-SOD1 fusion protein could be efficiently transduced into HUVECs in a natively active form, and the delivered enzymatically active PEP-1-SOD1 exhibits cellular protection against hypoxia/reoxygenation injury in HUVECs. The transduction of SOD1 mediated by cell-penetrating peptide, PEP-1, provides a basis for further research on the prevention of ischemia/reperfusion injury in vivo.

Cell Hypoxia ; Cells, Cultured ; Cysteamine ; analogs & derivatives ; metabolism ; Endothelial Cells ; cytology ; Humans ; Malondialdehyde ; metabolism ; Peptides ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism ; Reperfusion Injury ; prevention & control ; Superoxide Dismutase ; genetics ; metabolism ; Transduction, Genetic ; Umbilical Veins ; cytology

The fruiting body pattern is an important agronomic trait of the edible fungus Auricularia auricula-judae, and an important breeding target. There are two types of fruiting body pattern: the cluster type and the chrysanthemum type. We identified the fruiting body pattern of 26 test strains, and then constructed two different near-isogenic pools. Then, we developed sequence characterized amplified region (SCAR) molecular markers associated with the fruiting body pattern based on sequence-related amplified polymorphism (SRAP) markers. Ten different bands (189–522 bp) were amplified using 153 pairs of SRAP primers. The SCAR marker “SCL-18” consisted of a single 522-bp band amplified from the cluster-type strains, but not the chrysanthemum strains. This SCAR marker was closely associated with the cluster-type fruiting body trait of A. auricula-judae. These results lay the foundation for further research to locate and clone genes controlling the fruiting body pattern of A. auricula-judae.
Breeding ; Chrysanthemum ; Cicatrix ; Clone Cells ; Fruit* ; Fungi

rats.

Objective:To investigate the risk factors of thrombocytopenia in elderly patients with sepsis-associated acute kidney injury(SA-AKI), and to further evaluate whether the degree of thrombocytopenia is related to the increased risk of death on day 28.Methods:Elderly patients with SA-AKI admitted to ICU of our hospital from June 2017 to June 2020 were selected.The patients were divided into normal platelet group(56 cases)and thrombocytopenia group(72 cases)according to the platelet(PLT)count, and according to the degree of thrombocytopenia, they were further divided into three groups: PLT<20×10 9/L(group A, 22 cases), 20×10 9/L≤ PLT<50×10 9/L(group B, 27 cases), 50×10 9/L≤ PLT<100×10 9/L(group C, 23 cases).The general data, clinical baseline indicators and prognostic indicators of each group were compared to evaluate the risk factors of thrombocytopenia.At the same time, the impact of platelet count on the prognosis of elderly patients with SA-AKI was evaluated according to the length of stay in ICU, total length of stay and whether the patient died, and the correlation between the degree of thrombocytopenia and survival was analyzed. Results:A total of 128 elderly patients with SA-AKI were enrolled, including 73 males and 55 females.59.4 % of the patients were hospitalized in the department of internal medicine.The APACHEⅡ score was(15.5 ± 3.3)points, invasive mechanical ventilation accounted for 78.9%, positive inotropic therapy accounted for 12.8%, and 56 patients had normal platelet count.Thrombocytopenia occurred in 72 patients, including 22 patients with PLT<20×10 9/L, 27 patients with platelet count in 20-50×10 9/L, and 23 patients with platelet count in 50-100×10 9/L.There were significant differences in bloodstream infection, Gram-negative bacteria, APACHEⅡ score and procalcitonin(PCT)among the four groups( P<0.05).Further multivariate logistic regression showed that PCT was an independent risk factor for thrombocytopenia in elderly patients with SA-AKI( OR=1.05, 95% CI: 1.00-1.10, P=0.042).Compared with the normal platelet group, the 28-day mortality rate of the thrombocytopenia group was significantly higher than that of the normal platelet group, while the length of stay in ICU and the total length of stay were prolonged( P<0.05).Kaplan-Meier survival curve showed that the 28-day cumulative survival rate of thrombocytopenia group was lower than that of normal platelet group, and the risk of death increased with the degree of thrombocytopenia( χ2=31.479, P<0.001).Univariate Cox regression analysis showed that thrombocytopenia, bloodstream infection, APACHEⅡ score and PCT were risk factors for 28-day death in elderly patients with SA-AKI.Multivariate Cox analysis showed that bloodstream infection and APACHEⅡ score were independent risk factors for 28-day death.After adjusting these confounding factors, thrombocytopenia was an independent risk factor for death, and the degree of thrombocytopenia was related to the increased risk of death. Conclusions:Thrombocytopenia is common in elderly patients with SA-AKI, and elevated PCT levels increase the risk of thrombocytopenia.The degree of thrombocytopenia is an independent risk factor for 28-day mortality in such patients.

Objective To define the anatomical characteristics of the insula and its relation with its surrounding structures that can lead to precisely design the microsurgical approaches of the insular region.Methods We analyzed the head data of 15 Chinese adult cadavers(30 hemispheres)fixed by 10% formalin.The relative anatomical landmarks of the insular region and the distance from the insula to its peripherally correlative structures were measured and described. Results The insula,being one of the paralimbic structures,constituted the invaginated portion of the cerebral cortex and formed the base of the sylvian fissure.The insula was covered and enclosed by the frontoorbitsl,frontoparietal and temporal opercula and the transmigrated part of the insula was the uncinate extreme capsule,the white matter region inferior to the insular cortex.The insula was adjacent to the external capsule,the claustrum,the internal capsule,the lenticular nucleus,the caudate nucleus and the thalamus.The insula separated the endbrain and the limbic structures like an inverted pyramid.Various unique anatomical features of the insula and the peripheral relations with the insula were determined by using the fiber dissection techniques.Conclusion A good understanding of the surgical anatomy,being extremely important for a neurosurgeon, can guide us to operate for such series of frequent and multiple diseases aS hypertensive intracerebral hemorrhage from the basal ganglia,the insular glioma and temporal lobe epilepsy in the neurosurgery.