Objective To study the perinatal outcomes in pregnant women with pathogens of toxoplasma,cytomegalovirus and herpes simplex type Ⅱ in maternal blood.Methods 1 141 preg- nant women were screened for toxoplasma,eytomegalovirus and herpes simplex type Ⅱ by PCR in maternal blood during 1994.2～1997.3.Some placental tissues and/or umbilical vein blood were also detected.Results Toxoplasma,cytomegalovirus,or herpes simplex type Ⅱ were positive in 97 cases(8.50%).All cases,except that 25 cases did not deliver in our hospital,were followed up to 42 days postpartum.Fifty-two cases got good perinatal outcomes,while 20 cases had poor perinatal outcomes.17 placentas were detected in patients with good perinatal outcomes,while 15 placentas were detected in patients with poor perinatal outcomes.The positive rates of toxoplasma,cytomega- lorirus and herpes simpley type Ⅱ in the two groups were 17.65%(3/17)and 60.00%(9/15)re- spectively(P

Objective: To evaluate the feasibility of hypofractionated intensity-modulated radiation therapy (IMRT) combined with concurrent chemotherapy in patients with locally advanced squamous cell carcinoma of the hypopharynx. Methods:Patients with stageⅢ-ⅣA carcinoma of the hypopharynx were treated with IMRT and cisplatin-based concurrent chemotherapy. Two groups were di-vided according to the prescription dose to the primary gross tumor volume, as follows:Cohort-1 comprised patients who were recruit-ed before February 2013 (70 Gy/33 F and 2.12 Gy/F);and Cohort-2 comprised patients who were recruited since February 2013 (69 Gy/30 F and 2.30 Gy/F). Acute toxicities were evaluated. This study was registered with the number ChiCTR-ONRC-14004240. Results:Between August 2008 and December 2014, a total of 76 patients (35 in Cohort-1 and 41 in Cohort-2) were recruited. No xerostomia of grade 3 and higher was observed in all patients, who showed low incidences of grade 3 skin reaction, oral mucositis, and dysphagia. All patients did not show acute toxicities of higher than grade 4. No statistical differences in acute toxicities were observed between the two cohorts. No statistical difference was observed in acute toxicities between the IMRT techniques. Induction chemotherapy was the inde-pendent prognostic factor for grade 2 xerostomia (P=0.002). Conclusion:The 69 Gy/30 F hypofractionated IMRT was safe and effec-tive in the treatment of locally advanced squamous cell carcinoma of the hypopharynx. Late toxicities and long-term outcome need to be investigated further.

Objective To investigate the values of conventional magnetic resonance imaging (MRI),magnetic resonance angiography (MRA),and high-resolution MRI for diagnosing intracranial arterial dissection (IAD)caused ischemic stroke. Methods From August 2008 to April 2015,59 consecu-tive patients (age 45 ±15years,41males)with IAD caused ischemic stroke admitted to the First Affiliated Hos-pital of Sun Yat-Sen University were enrolled prospectively. All patients underwent conventional cranial MRI/MRA examination,25 of them underwent whole brain DSA examination,and 10 underwent high-resolution MRI. The findings of conventional MRI/ MRA and high-resolution MRI of IAD were analyzed. For patients undergoing DSA,the proportions of detection and compliance of IAD were compared between DSA and conventional MRI / MRA. Results (1)Conventional MRI / MRA revealed typical sign of artery dissection in 42 patients (71. 2%),among them,the intramural hematoma (n = 22,52. 4%)was most common. Other common signs included intimal flap/ double lumen sign (n = 13,31. 0%)and long irregular or thread-like stenosis (n = 9,21. 4%);while dissecting aneurysm (n = 7,16. 7%)and rat tail-shaped occlusion (n = 3, 7. 1%)were relatively rare. In 17 patients (28. 8%)with IAD that conventional MRI/ MRA did not detect the typical dissection sign,the dissections were involved in the middle cerebral artery (11 / 17,64. 7%), they were more common than the 42 patients with IAD (10 / 42,23. 8%)detected the typical dissection sign by conventional MRI/ MRA. There was significant difference (P = 0. 006). (2)Among the 25 patients undergoing DSA,DSA revealed that 15 patients (60%)had the typical dissection sign,and conventional MRI/ MRA only revealed 8 of them (32%)with the typical dissection sign,but there was no significant difference (P = 0. 088). In 15 patients with IAD that DSA detected the typical dissection sign;conventional MRI / MRA detected the typical dissection sign in 8 of them. The diagnostic coincidence rate was 8 / 15. (3)Both conventional MRI/ MRA and DSA revealed non-specific limitation stenosis or cut-off occlusion in 10 patients (16. 9%)with IAD,while the high-resolution MRI revealed intimal flap in 5 of them,intramural hematoma in 4,and intimal flap and intramural hematoma in 1. Conclusion Conventional cranial MRI/MRA is an effective technique for revealing IAD,whereas high-resolution MRI has the unique advantages for diagnosing IAD without typical dissection in other vascular imaging.

Objective To analyses the magnetic resonance imaging(MRI)findings of different clinical patterns of neurosyphilis(NS).Methods Clinical records and MRI of 26 patients with NS were retrospectively studied.Results Abnormal MRI was found in 17 patients of 26 patients with NS.In 7 patients were with meningo-vascular syphilis,the MRI commonly showed multiple cerebral ischemia focus and cerebral infarction focus,very few similar to those of encephalitis;Six patients had general paresis,who presented cerebral MRI abnormalities of frontal and temporal atrophy,and few simultaneously with cerebral ischemia focus,granular apendymitis and hippocampus sclerosis;Three patients had syphilitic myelitis,their MRI showed mild tumefaction with multiple ischemic focus all the way through lower cervical spinal cord to lower thoracic spinal cord:One patient was with tabes dorsalis,whose cerebral MRI showed ischemic locus.Another 9 patients had normal MRI,of whom 4 patients with meningitis NS and 5 with tabes dorsalis.Conclusion The MRI of neurosyphilis has diverse presentations,and clinicians should pay much attention to it.

Objective:To investigate the clinical manifestations, pathological characteristics, treatment and prognosis of pediatric rheumatic carditis with the initial symptom of acute heart failure, and to improve the clinical understanding of the disease.Methods:The clinical data, laboratory examination results, imaging findings, treatment and prognosis data of 10 cases with acute rheumatic carditis were collected and analyzed retrospectively.The patients pre-sented with acute heart failure as the first symptom and were treated in Shenzhen Children′s Hospital from January 2015 to February 2022.Results:There were 4 males and 6 females in this study.The mean age was 9.1 years (3 years and 1 month to 11 years and 3 months), and the average onset age was (9.3 ± 3.2) days (4-14 days). All the 10 cases had circulation symptoms.Besides, 4 cases were also complicated with joint symptoms, 3 cases with neurological symptoms and 2 cases with skin symptoms.Echocardiography revealed mitral valve diseases in all cases.More specifically, combined valve diseases were found in 5 cases, pure mitral regurgitation in 3 cases, and mixed mitral valve diseases (mitral regurgitation complicated with mitral stenosis) in 2 cases.After receiving antibiotic therapy, anti-infection treatment and anti-heart failure therapy, symptoms improved in all patients and valve lesions were alleviated.All patients were followed up for 6 months to 6 years.Six cases had persistent rheumatic heart disease during the follow up.Conclusions:Pediatric rheumatic carditis with the initial symptom of acute heart failure is characterized by early onset and the typical manifestation of rheumatic fever.Mitral valve disease is the commonest lesion.Echocardiography is of great value for the early diagnosis of the disease.Medical treatment is effective, but the incidence of chronic rheumatic heart disease is still high.

Objective:To develope and analyze and optimize the performance of some kinds of environmentally friendly flexible X-ray protective materials in attempt to tackle the various environmental and high energy consumption problems in the development of traditional medical X-ray protective clothing.Methods:The Monte Carlo program was used to establish a simplified model of medical X-ray tube. The aim was to carry out numerical simulation and prediction of the shielding materials′ performance against X-ray, prepare the flexible X-ray shielding materials through experiments and test and verify the their shielding performances The development and optimization path was also obtained by comparing the result between simulation and experiment.Results:Bi was the preferred alternative to toxic Pb elements, while W was able to compensate for weak X-ray absorption zone of Bi. The shielding efficiency of the composite material doped with 25% Bi+ 25% W was able to reach 77.8% and 66.3% at 80 and 120 kV p tube voltages, respectively. Conclusions:With both the selection of elements and the optimization of functional particles, the combination of W and Bi is an economical, environmentally friendly, and efficient shielding way within the energy range of medical diagnostic X-rays. The numerical simulation helps reduce experimental costs, shorten the research period, and improve the design efficiency of X-ray shielding materials.

Objective:To evaluate the effectiveness of interventional treatment for neonatal critical pulmonary stenosis(NCPS).Methods:Clinical data of 12 neonates with NCPS who received percutaneous balloon pulmonary valvuloplasty (PBPV) from January 2016 to December 2019 in Department of Cardiology, Shenzhen Children′s Hospital were summarized and analyzed.The collected data included transthoracic echocardiography (TTE), percutaneous oxygen saturation (SPO 2), relevant data on interventional surgery, and follow-up results. Results:All 12 neonates with NCPS received PBPV successfully.The postoperative pressure difference between the right ventricle and the pulmonary artery ranged from 8 to 35 mmHg[(20±7) mmHg, 1 mmHg=0.133 kPa]. The postoperative SPO 2 ranged from 74%-100%[(93.0±5.9)%]. Three neonates with NCPS received Blalock-Taussig (B-T) shunt.One neonate with NCPS developed supraventricular tachycardia during the operation.There was no death for these 12 neonates with NCPS. Conclusions:Interventional treatment of neonates with NCPS could achieve a better effect and be employed as the first treatment option.Some neonates with NCPS would require cardiac B-T shunt or patent ductus arteriosus stent implantation.

Objective To investigate the protective and treatment role of ulinastatin(UTI)on con-trast-induced acute kidney injury(CIAKI)in the elderly with coronary heart disease(CHD)and chronic kidney diseases(CKD).Methods A total of 321 elderly CHD inpatients complicated with CKD undergoing coronary angiography admitted in the First Medical Center of Chinese PLA Gen-eral Hospital from November 2021 to November 2022 were enrolled consecutively and then divid-ed into UTI group(n=161)and hydration group(n=160).Their cardiac and renal function pa-rameters were collected and analyzed before and 2 d after intervention.The changes in above pa-rameters and incidence of CIAK were observed and compared between the two groups.Results In 2 d after intervention,the UTI group had significantly lower Scr,urea,CysC,homocysteine and NT-proBNP,but higher eGFR than the hydration group(P＜0.01).There were 62 patients(62/321,19.3％)developing CIAKI,including 17 from the UTI group and 45 from the hydration group,and statistical difference was observed in the incidence(10.6％vs 28.1％,P＜0.01).For the patients with comorbidities of hypertension,diabetes,hyperlipidemia and hyperuricemia,the incidence of CIAKI was obviously lower in the UTI group than the hydration group(P＜0.01).Multivariate logistic regression analysis showed that UTI was an independent protective factor for occurrence of CIAKI(OR=0.348,95％CI:0.180-0.673,P=0.001).Conclusion UTI can im-prove renal function and reduce the risk of CIAKI in elderly CHD patients with CKD.

This study explores the effects of enhancing the definitive hematopoiesis(DH)signals during the differentiation of human embryonic stem cells(hESCs)into hematopoietic stem/progenitor cells on the generation efficiency and effector function of natural killer(NK)cells generated from hESCs(also known as hESC-NK cells).The hESC(H1)were transformed into embryoid bodies(Ebs)by centrifugation,and during the induction of K562,were used to analyze the efficiency of hematopoietic differentiation,the efficiency of NK cell generation from hESC,the in vitro effector functions,and the expression of effector function related surface receptors.Compared to the control group,the DH group had a significant increase in the number of arterial hematopoietic endothelial cells(CD34+DLL4+)and a significant decrease in primitive hematopoietic related cells(CD34-CD43+)on day 8 of hematopoietic differentiation(P<0.05).On day 28 of NK cell differentiation,the DH group demonstrated a significant increase in the number of NK cells(CD45+CD56+),while a slight increase in the expression of effector function-related molecules such as IFN-γ,Granzyme B,Perforin and CD107a without statistical significance.Furthermore,the activation receptors CD16a and CD69 were significantly increased,NKP46 was significantly decreased,the inhibitory receptor NKG2A was significantly increased,while CD96 was significantly decreased on hESC-NK cells of DH groups(P<0.05).Conclusively,enhancing the signals for definitive hematopoiesis during hESC differentiation into hematopoietic stem/progenitor cells significantly improves the yield of NK cells and the expression of CD16a without affecting their in vitro effector functions.Our study provides a new approach to improving the efficiency of hESC-NK cell or iPSC-NK cell generation.

Three female workers in a golf club production company in Guangzhou were diagnosed with occupational chronic mild benzene poisoning. Two of the female workers were assessed as Grade 7 disabilities. One female worker showed the symptoms of the decline of whole blood cells for unknown reasons in the later stages of the medical period. The final assessment was a Class 5 disability. The problems in this work ability appraisal include: the injury condition of the patient who has not been stable during the work ability appraisal, and the contradiction between the disability grade and the occupational disease diagnosis conclusion. In order to avoid similar situations, the following recommendations are recommended: after the worker's injury situation is relatively stable, the assessment will be conducted, the employer will actively exercise the right to review and appraisal, and the diagnosis of occupational diseases will be included in the evaluation criteria for disability grade.