Bleeding Time ; Child, Preschool ; Female ; Hemorrhage ; diagnosis ; Humans ; von Willebrand Diseases ; diagnosis

Objective To evaluate the feasibility of leucovorin(LCV) rescue protocol defined by us,we compared the plasma concentrations,toxicity,LCV doses of different high doses methotrexate(HD-MTX).Methods Seventeen children with acute lymphoblastic leukemia and 1 children with non-Hodgkin′s lymphoma were randomly treated with total 43 courses of HD-MTX.MTX plasma concentrations were measured by fluorescence polarization immuno-assay.Different LCV rescue protocols were prospectively defined for 3 kinds of HD-MTX protocols.Adjusting LCV dose by plasma MTX concentrations.Results No irreversible MTX-related toxicity was observed in all patients.Significant differences of mean steady-state plasma concentrations(Cpss) and total rescue doses were found between 3 groups(P

Objective To investigate the clinical manifestations and the antibiotics resistance patterns in children with positive blood culture of Escherichia coli. Methods The clinical data of children with positive blood culture of Escherichia coli were retrospectively analyzed from Jan.2007 to Dec.2014. Results In a total of 154774 children who had blood culture in the study period, 8446 children were positive, among whom 408 (4.83%) children were isolated Escherichia coli. The children with the positive blood culture of Escherichia coli mainly were under one year old (51.72%), of which 36.77%was neonates. There were 275 children had underlying diseases, and the most common disease was Leukemia. 199 (48.77%) Escherichia coli strains were producing extended spectrumβ-lactamase (ESBLs) and 85.23%were resistant to ampicillin. All strains were susceptible to meropenem. Conclusions Septicemia caused by Escherichia coli is usually occurred in children with leukemia or in neonates. Since blood infections of Escherichia coil had high rate of ESBLs, the use of carbapenem antibiotics should be cautious.

AIM: To discuss the effects of preoperative vitreous cavity injection of ranibizumab on 25G minimally invasive vitreoretinal surgery (VRS) in patients with proliferative diabetic retinopathy(PDR).METHODS: From February 2013 to December 2015,74 patients with PDR received VRS (82 eyes) were retrospectively analyzed.Patients were divided into VRS + IVR group and VRS group according to preoperative VRS treatment.VRS+IVR group: preoperative injection of ranibizumab (10mg / mL) at 3-5d before operation;VRS group: VRS only.We recorded VRS operation time,filling situation,iatrogenic retinal hole and so on.RESULTS: The operation time and coagulation times of VRS+IVR group were significantly lower than VRS group.The two groups in operation time and coagulation times were statistically significant (all P<0.05).In the VRS+IVR group,the number of cases of iatrogenic retinal hole and the use of silicone oil were lower than those of VRS group,the difference between the two groups was statistically significant (P<0.05).While the use number of C3F8 and perfusion fluid were not statistically significant (P>0.05).In VRS-IVR group within 3mo after operation,4 eyes appeared to vitreous body hematocele,VRS group was 13 eyes,the difference was statistically significant (x2=4.966,P<0.05).CONCLUSION: PDR patients with 25G minimally invasive VRS with preoperative therapy can reduce postoperative ocular bleeding,rate of retinal injury and silicone oil filling,shorten the operation time,the incidence rate and improve the success rate of surgery and reduce eye bleeding,postoperative complications such as adhesion.

Objective:To develop an experimental three-dimensional model by ECV304 cells(human umbilical vein endothelial cell line) for investigating the mechanisms of angiogenesis in vitro.Methods:ECV304 cells were seeded onto three-dimensional collagen gels made of rat-tail collagen.When the endothelial cells were cultured and grown to near confluence,treated with bFGF for 3 to 12 days,and then assessed with inverted phase contrast microscope.Results:The endothelial cells migrated into the gels,formed complex networks by cell cords at different levels through the bottom view,and sprouted capillary-like structures through the side view.Conclusion:ECV304 cells are capable of expressing some early events of angiogenesis in the three-dimensional collagen gels:proliferating,migrating and sprouting and so on.It should be useful for studying angiogenesis in vitro.

Abstract Type 2 diabetes mellitus (T2DM) is characterized by long duration of disease and latent onset. Risk prediction models have shown potential for f early diagnosis and early treatment of diseases and formulation of targeted interventions. There is an increase in researches on risk prediction models for T2DM during the recent years, which provides the basis for precision tertiary prevention of T2DM; however, most studies suffer from problems of small sample size, complicated variables and difficulty in extensive applications. This review summarizes the risk prediction models for T2DM based on economic and easily available routine physical examination indicators, so as to provide insights into further studies on easy-to-perform and -popularize risk prediction models for T2DM.

Objective To compare different susceptibility testing methods of tigecycline against Acinetobacter baumannii and Klebsiella pneumoniae.Methods Fifty carbapenem-resietant A.baumannii (CRAB) strains and 49 K.pneumoniae strains were collected from Tianjin Medical University General Hospital during January and March 2012.Minimum inhibitory concentration (MIC) and inhibitory zone diameters for tigecycline were determined by broth microdilution,Vitek-2,MTS and disk diffusion methods.The results of Vitek-2,MTS and disk diffusion methods were compared with those of broth microdilution method.Results According to FDA standards,the susceptibilities of CRAB and K.pneumoniae to tigecycline determined by broth microdilution,Vitek-2 and MTS were 94.0％/91.8％,68.0％/91.8％ and 90.0％/91.8％,respectively.For CRAB isolates,the essential agreement (EA) and categorical agreement (CA) produced by Vitek-2 and MTS were 94.0％/72.0％ and 92.0％/90.0％.MICs determined by Vitek-2 were 1-2 dilutions higher than the reference method in 33 (66.0％) strains,and those determined by MTS were higher in 16 (32.0％) strains and lower in 11 (22.0％) strains.For K.pneumoniae isolates,the EA/CA produced by Vitek-2 and MTS were 95.9％/98.0％ and 83.7％/91.8％,respectively.MICs determined by Vitek-2 were 1-3 dilutions lower than the reference method in 17 (34.7％) strains,and those determined by MTS were 1-3 dilutions lower than the reference method in 39 (79.6％) strains.None of thetwo methods produced very major error (VME) and major error (ME) against two kinds of isolates.The results were determined by disk diffusion method using different breakpoints according different isolates.For CRAB,using ≥14 mm/≤ 10 mm as breakpoint,CA was 94.0％,which was higher than the breakpoint recommended by Jones et al (≥16 mm/≤12 mm,CA was 82.0％) ; and for K.pneumoniae,using the ≥ 14 mm/≤ 10 mm as breakpoint,CA was 93.9％,higher than the FDA Enterobacteriaceae breakpoint (≥ 19 mm/≤ 14 mm,CA was 67.3％).Conclusion For CRAB strains,MTS produces better consistence with broth microdilution,with several higher or lower MIC results.For K.pneumoniae strains,Vitek-2 has better correlation with reference method,with several lower MIC results.The consistence between disk diffusion method and broth microdilution is comparatively lower,and the breakpoint should be adjusted according to different bacteria.

Adult ; Device Removal ; Equipment Failure ; Female ; Foreign-Body Migration ; surgery ; Heart Septal Defects, Atrial ; surgery ; Humans ; Myocardial Revascularization ; adverse effects ; instrumentation ; Postoperative Complications ; etiology

AIM: To research the application analysis of trabeculectomy combined with phacoemulsification treating patients with primary angle-closed glaucoma ( PACG) and cataract.
METHODS: Seventy-three patients from September, 2011 to September, 2013, with primary angle- closed glaucoma and cataract, were selected in our research. Patients were all treated with trabeculectomy combined with ultrasonic emulsification, and the therapeutic effect was observed.
RESULTS: The effects of trabeculectomy combined with phacoemulsification treating primary angle-closed glaucoma and cataract in reducing intraocular pressure were better, and postoperative visual acuity results of the research objects were satisfactory. And it could deepen the central anterior chamber depth effectively. All the research objects had few complications.
CONCLUSION: Trabeculectomy combined with phacoemulsification treating primary angle - closed glaucoma and cataract can achieve a good result for reducing intraocular pressure, postoperative visual acuity recovery and correction, and the surgical success rate is high, with low complication rates. It is worthy of widely clinical application.

Objective:To analyze the clinical and gene mutation characteristics of congenital disorder of glycosylation (CDG) caused by compound heterozygous mutation of the COG6 gene ( COG6-CDG). Methods:This study retrospectively analyzed the clinical data and genetic test results of a patient with COG6-CDG in Bayi Children's Hospital, the Seventh Affiliated Medical Center of Chinese PLA General Hospital, in August 2019. Literature was retrieved with keywords including COG6, COG6-CDG, congenital disorders of glycosylation typeⅡL and congenital disorders of glycosylationⅡL in China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, and Web of Science Database from the establishment to July 2020, to summarize the clinical and genetic characteristics of COG6-CDG. Results:(1) Case report: The 59-day-old baby boy, with a gestational age of 27 +5 weeks and birth weight of 1 180 g, presented with multi-system involvement on admission, including unidentified progressive hepatosplenomegaly with jaundice and ascites, persistent thrombocytopenia, microcephaly, hypotonia, hypohidrosis, hyperkeratosis, and recurrent hyperthermia, infection, and hypoglycemia, as well as dysfunctions of the heart, gastrointestinal tract, lungs, kidneys, ocular fundus, and the coagulation system. Despite given ventilator-assisted ventilation, anti-infection therapy, abdominal puncture and drainage, and blood transfusion, the patient still had an aggravated condition and eventually died of multiple organ failures 192 d after birth. Genetic analysis showed that the nuclear family carried compound heterozygous mutations in the COG6 gene (NM_020751.2), including missense mutations of c.662C>T(p.T221M) in exon 7 and c.443T>C(p.I148T) in exon 5, which were both novel mutations and originated from the mother and father, respectively. (2) Literature review: Eight related papers were retrieved, including 20 cases. The main manifestations were various degrees of nervous system abnormalities and growth retardation, complicated by abnormalities of the liver, heart, gastrointestinal tract, blood, immunity, teeth, and bones. All the reported cases suffered from mental and growth retardation, and nine deaths were reported. A total of 11 COG6 gene mutations were identified, and most of them were c.1167-24A>G splicing mutations in a deep intron (seven cases), followed by c.1646G>T (four cases) and c.511C>T (three cases). Conclusions:COG6-CDG commonly manifests as multi-system and multi-organ dysfunctions with poor prognosis. Gene detection is conducive to the accurate diagnosis of COG6-CDG. Our case carries compound heterozygous mutations of c.662C>T(p.T221M) and c.443T>C(p.I148T), which are unreported novel mutations.