Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

A simple, sensitive and reliable method was developed for simultaneous determination of ten banned drugs residues including zeranols(ZALs),chloroamphenicol,pentachlorophenol,etc. in swine urine using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The urine samples were pretreated using lyophilization and QuEChERS procedures, respectively. Acetonitrile and ammonium acetate (5 mmol/L) were chosen as mobile phases. Target compounds were separated well in ZorbaxSB-C18by following the optimized gradient elution program and determined by LC-MS/MS in negative electrospray ionization mode. The linearity of the matrix-matched standard curve of ten analytes in two methods was good in the range of the experimental concentration with correlation coefficients more than 0.99. The recoveries of ten drugs were in the range of 80.7%-107.7% and 73.5%-103.3% at the spiked levels of 5,10 and 20 μg/L by lyophilization and QuEChERS methods,respectively. The coefficients of variation were less than 15%. The limits of detection (LOD) and the limits of quantification (LOQ) from lyophilization and QuEChERS method were 0.1 to 2.0 μg/L and 0.2 to 5.0 μg/L,respectively.

Objective To establish the three-dimensional finite element model of human lower cervical spine C3-7 motion segments after anterior cervical corpectomy and fusion (ACCF) surgery with titanium mesh and bone graft, and to analyze the stability of cervical spine and stress distribution of internal fixation devices after ACCF surgery. Methods The finite element model of cervical spine C3-7 segments after ACCF of C5 segment with titanium mesh, bone graft, plate and screw fixation was established，and C3-7 segment intact model of cervical vertebra was also constructed. The torque moment of 0.5, 1.0, 1.5, 2.0 N﹒m was applied to the ACCF surgery model. The ROM, maximum stress in facet joint and stress distributions on internal fixation devices under flexion, extension, lateral bending and torsion movement were analyzed. Results ROM of reconstructed C5 segment increased with the torque moment increasing after ACCF surgery. In the case of 1.0 N﹒m torque moment and 50 N preload, the ROM of reconstructed C5, C3-4, C6-7 and C3-7 segment was reduced by 81%, 62%, 58% and 80% compared with the intact model. The maximum stress in facet joint of reconstructed C5 segment reduced and the stress in adjacent segments significantly increased. The stress of titanium mesh was mainly distributed on the compression side of movement, and high stress was located in the roots of screws. Conclusions ACCF surgery can promote the stability of cervical spine, decrease the stress in facet joint of operation segment, and has better treatment effect on easing compression from spinal cord caused by cervical spondylotic myelopathy. The research results will provide some theoretical basis for clinical application of ACCF.

Objective To establish the three-dimensional finite element model of human lower cervical spine C3-7 motion segments after anterior cervical corpectomy and fusion (ACCF) surgery with titanium mesh and bone graft,and to analyze the stability of cervical spine and stress distribution of internal fixation devices after ACCF surgery.Methods The finite element model of cervical spine C3-7 segments after ACCF of C5 segment with titanium mesh,bone graft,plate and screw fixation was established,and C3-7 segment intact model of cervical vertebra was also constructed.The torque moment of 0.5,1.0,1.5,2.0 N · m was applied to the ACCF surgery model.The ROM,maximum stress in facet joint and stress distributions on internal fixation devices under flexion,extension,lateral bending and axial rotation movement were analyzed.Results ROM of reconstructed C5 segment increased with the torque moment increasing after ACCF surgery.In the case of 1.0 N · m tomue moment and 50 N preload,the ROM of reconstructed C5,C3-4,C6-7 and C3-7 segment was reduced by 81％,62％,58％ and 80％ compared with the intact model.The maximum stress in facet joint of reconstructed C5 segment reduced and the stress in adjacent segments significantly increased.The stress of titanium mesh was mainly distributed on the compression side of movement,and high stress was located in the roots of screws.Conclusions ACCF surgery can promote the stability of cewical spine,decrease the stress in facet joint of operation segment,and has better treatment effect on easing compression from spinal cord caused by cervical spondylotic myelopathy.The research results will provide some theoretical basis for clinical application of ACCF surgery.

Objective:To investigate the correlationship between early morning blood pressure ,brachial‐ankle artery pulse wave velocity (baPWV ) and risk factors of cardiovascular diseases (early morning blood ,blood lipid ,blood glucose , homocysteine [HCY] ,glomerular filtration rate [eGFR] ,carotid artery plaque) .Methods:Early morning blood pressure was monitored in 297 patients with primary hypertension ,and baPWV ,blood lipid ,blood glucose ,HCY ,eGFR and carotid artery color Doppler were examined .SAS 9 .2 was used to analyze the relationship between baPWV and early morning blood pressure , blood lipid ,blood glucose ,HCY ,carotid plaque and age .The independent risk factors of baPWV were analyzed by regression analysis (Stepwise) .Results:BaPWV was significantly correlated with age ,early morning blood pressure ,low density lipoprotein cholesterol (LDL‐C) ,eGFR and carotid artery plaque (P< 0 .05) .BaPWV was not significantly correlated with fasting glucose or HCY .The regression analysis showed that the early morning blood pressure ,LDL‐C and carotid artery plaque were the independent risk factors of baPWV ( P < 0 .05 ) . Conclusions: The early morning hypertension and hypercholesteremia are correlated with arteriosclerosis in patients with essential hypertension .

Objective To study biomechanical properties such as range of motion (ROM), intervertebral disc stress, ligament tension of inferior cervical spinal segment after the treatment of Discover, Prodisc-C artificial intervertebral disc replacement, and anterior cervical discectomy and fusion (ACDF), as well as mechanical property changes of the prosthesis after implantation. Methods Three kinds of operation plan on C5-6 cervical disc degeneration were established: Discover model, Prodisc-C model and ACDF model, as well as C4-7 segment original model of cervical vertebra. Biomechanical property changes after operation in cervical spine C4-7 segment in sagittal, coronal and transverse section were analyzed. Results ROM changes of cervical segment C5-C6 were as following: in Discover model it increased by 12.7%-73.1%, Prodisc-C model increased by 74%-98%, ACDF decreased by 55.8%-71.8%. The stress of C4-5 intervertebral disc after Discover artificial disc replacement showed no obvious increase, while the stress of C6-7 intervertebral disc decreased by 33.2%-54.2% under flexion, extension and axial rotation conditions. The amplification of ligament tension in Discover model decreased by 30%-40% as compared to that in Prodisc-C model. The maximum stress of Discover model (36.72 MPa) appeared under flexion condition, which was smaller than that in Prodisc-C model. Conclusions Artificial disc replacement can help to keep movement performance for segment after surgery. As a newly developed artificial intervertebral disc prosthesis, Discover makes some progress in the aspect of decreasing ligament stress and maintaining spinal stability. The research findings will provide theoretical basis for the clinical study on ACDF and artificial cervical intervertebral disc replacement surgeries.

OBJECTIVETo explore the impact of IFN-γ + 874 polymorphisms on the outcome in HLA matched sibling HSCT.

METHODSWe used PCR-sequence-specific primer analysis (PCR-SSP) to analyze the polymorphisms of IFN-γ + 874 T/A in 80 recipient and donor pairs from October 2005 to March 2008.

RESULTSRecipients having donors who possessed IFN-γ + 874 A/A genotype had significantly earlier neutrophil recovery compared with those having donors with non-A/A genotype (15 (11 - 27) days vs 18 (12 - 30) days, P = 0.029). And IFN-γ + 874 A/A in both recipients and donors further facilitated neutrophil recovery compared with others (13 (11 - 25) days and 19 (12 - 31) days, P = 0.019). Besides, IFN-γ + 874 A/A in recipients increased the probability of grade II-IV acute graft versus disease (aGVHD) and cytomegalovirus viraemia compared with IFN-γ + 874 T/A or T/T genotype (20% vs 4% P = 0.041, 43.6% vs 16.0% P = 0.032), which lead to increased 5-year transplant-related mortality (TRM) (33.7% ± 6.8% vs 12.0% ± 6.5%, P = 0.050) and decreased 5-year event free survival (EFS) \[(58.2 ± 6.7)% vs (84.0 ± 7.3)%, P = 0.032\] compared with the latter. IFN-γ + 874 A/A in both recipients and donors also significantly increased the probability of grade II-IV aGVHD and cytomegalovirus viraemia compared with the other (21.7% vs 5.9%, P = 0.050; 45.7% vs 20.6%, P = 0.020), which caused increased 5-year TRM \[(31.6 ± 7.5)% vs (13.6 ± 6.5)%, P = 0.048\] and decreased 5-year EFS \[(56.8 ± 7.3)% vs (79.4 ± 6.9)%, P = 0.037\] compared with the other.

CONCLUSIONIn HLA-matched sibling HSCT setting, the presence of IFN-γ + 874 T allele in recipients or in both recipients and donors significantly decreased the risk of grade II-IV aGVHD and CMV infection and increased EFS. While IFN-γ + 874 A/A in donors or in both recipients and donors was associated with shorter duration to neutrophil recovery.

Adolescent ; Adult ; Alleles ; Child ; Child, Preschool ; Female ; Genotype ; HLA Antigens ; immunology ; Hematologic Diseases ; genetics ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Interferon-gamma ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Siblings ; Tissue Donors ; Transplantation, Homologous ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the incidence, risk factors, prognosis and high risk patients of invasive fungal infections (IFI) in patients with hematological diseases.

METHODS: Over 2-week hospitalized patients from January 2007 to December 2008 were retrospectively reviewed. Logistic regression was used to analyze the risk factors of IFI, and recursive partitioning to reveal high risk patients. Incidence of IFI was estimated by cumulative incidence function, and the prognosis by Kaplan-Meier method.

RESULTSA total of 1048 assessable treatment cycles were recorded and 93 cases of IFI were diagnosed, with an incidence of 8.87 per 100 treatment cycles. Multivariate logistic regression revealed the following risk factors: age (OR 1.025, 95% CI 1.010-1.041, P = 0.002), duration of neutropenia (OR 1.028, 95% CI 1.014-1.042, P < 0.0001) and uncontrolled underlying diseases (OR 2.620, 95% CI 1.608-4.268, P = 0.0001). Recursive partitioning found two groups of high risk patients: (1) patients with uncontrolled underlying diseases and neutropenia duration > or = 58 days (7/12, 58.3%), (2) patients with uncontrolled underlying diseases and age > or = 33 years (40/208, 19.2%). At the end of follow-up, 111 cases of IFI were recorded in 451 patients, with a 1-year cumulative incidence of 27.1%. In patients with established IFI, overall survival rate and IFI related mortality rate at 12 weeks after diagnosis were 83.4% and 13.5% respectively.

CONCLUSIONAge, duration of neutropenia and uncontrolled underlying diseases are risk factors of IFI; patients with uncontrolled underlying diseases and age > or = 33 years were at high risk of IFI and need major concern. IFI has a better prognosis and a lower related mortality in this study.

Female ; Hematologic Diseases ; diagnosis ; microbiology ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Incidence ; Logistic Models ; Male ; Multivariate Analysis ; Mycoses ; epidemiology ; Prognosis ; Retrospective Studies ; Risk Factors

Chronic myeloid leukemia (CML) at advanced and blastic phase is a disease with poor prognosis, for which allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only treatment choice with curative potential. This study was purposed to investigate the therapeutic efficacy of allo-HSCT and prognosis of advanced CML patients. The 28 cases of CML in accelerated phase or blast crisis received allo-HSCT were analysed retrospectively in terms curative efficacy, basic characteristics before transplant and prognosis, therapeutic strategy before transplant and prognosis, events after transplant and prognosis. The results indicated that 10 out of 28 patients were in complete remission, showing a 3-year overall survival and disease-free survival rate of 34.9% and 35.7% respectively; 18 patients died. Univariate analysis revealed that the clonal evolution and blast amount are baseline risk factor of poor prognosis, and combination of them can be used to predict the outcome of patients; application of imatinib before transplant and achievement of complete hematologic remission could not improve the prognosis; severe aGVHD among post-transplant events was proven to be a negative prognostic factor. It is concluded that for advanced CML patients received allo-HSCT, clonal evolution and blast percentage are prognostic factors, and the pre-transplant use of imatinib did not influence the outcome.
Adolescent ; Adult ; Benzamides ; Child ; Child, Preschool ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; surgery ; therapy ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Prognosis ; Pyrimidines ; therapeutic use ; Retrospective Studies ; Young Adult

This study was purposed to evaluate the outcome of patients with acute myeloid leukemia (AML) who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in complete remission, and to study the prognostic factors. 75 cases of AML in complete remission receiving allo-HSCT from January 2000 to December 2007 were retrospectively analyzed. Major end points of study included overall survival (OS), disease free survival (DFS), relapse rate and transplantation related mortality (TRM). The results showed that 3-year OS and DFS of the study population reached to 58.4% and 53.9% respectively, and the relapse rate and TRM leaded to 16.9% and 29.9% respectively. Incidence of acute GVHD was 59.6%, with 18.7% II-IV aGVHD. Different prognosis was observed between HSCT recipients of alternative donor and HLA-matched related donor (MRD) (3-year DFS was 34.3% vs 60.0%, p = 0.019), between patients of refractory leukemia and the control (3-year DFS was 35.7% vs 58.2%, p = 0.048), between recipients with and without severe aGVHD (3-year DFS was 35.7% vs 54.4%, p = 0.059). Further analysis revealed significantly high TRM in recipients receiving allo-HSCT of alternative donor (p = 0.033) and high rate of severe aGVHD (p = 0.010). Multivariate analysis revealed three negative prognostic factors: donor availability (alternative vs MRD) (p = 0.049, RR = 2.09, 95%CI 1.01 - 4.36), refractory leukemia (p = 0.038, RR = 2.33, 95%CI 1.05 - 5.20) and severe aGVHD (p = 0.040, RR = 2.33, 95%CI 1.04 - 5.20). It is concluded that allo-HSCT is a choice for the AML case at complete remission and TRM is the major cause of the transplantation failure. Donor availability, refractory leukemia and severe aGVHD are confirmed as risk factors of poor prognosis for allo-HSCT patients with AML in CR.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Graft vs Host Disease ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Leukemia, Myeloid, Acute ; mortality ; surgery ; Male ; Middle Aged ; Prognosis ; Recurrence ; Risk Factors ; Treatment Outcome ; Young Adult