Objective To discuss the clinical features of neonatal shock retrospectively.Methods Totally 144 neonates were enrolled in this retrospective study from Sep.2006 to Sep.2012 in NICU of Beijing Children's Hospital.Clinical data were collected from our database,including the primary disease,manifestation,laboratory findings,treatment and prognosis.Results According to the severity of shock,28 cases were mild,85 were moderate,31 were severe.Regarding to the type of shock,71 cases were cardiogenic shock,22 cases were hypovolemic shock,51 cases were septic shock.About 69.4％ patients were cured,only 9 cases died.Eight of them died of septic shock.Totally 33 cases in pH ＜7.15 group,2 of them died.In pH≥7.15 group,111 cases were involved,7 of them died.There was no significant difference of mortality between two groups (P =0.959).Conclusion Neonatal shock mostly occurred within 3 days after birth,and cardiogenic shock were dominating.Septic shock increased with age,and were responsible for death.

Objective To analyze the clinical and molecular features of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in neonates and to investigate their antibiotic resistance profiles.Methods A total of 35 invasive CA-MRSA strains were collected from six hospitals in 2014.Multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) typing and spa typing were used to analyze these isolated CA-MRSA strains.In vitro antibiotic susceptibilities of those strains to 15 antibiotics were analyzed by using agar dilution method.Results Up to 88.6% patients were late-onset infection and septicemia (24, 68.5%) was the most common infection among the 35 cases.A total of 16 patients (45.7%) suffered from complications.Caesarean section and premature birth were risk factors for invasive CA-MRSA infection.ST59-MRSA-SCCmecⅣa-t437 (14, 40%) was the most predominant CA-MRSA clone, followed by ST59-MRSA-SCCmecⅤ-t437 (13, 37.1%).The incidence of severe complications caused by ST59-MRSA-SCCmecⅤ-t437 was higher than that caused by ST59-MRSA-SCCmecⅣa-t437 (P<0.05).Up to 85.7% of the isolated CA-MRSA strains were multidrug-resistant strains.Conclusion This study shows that neonatal invasive CA-MRSA infections mainly result in septicemia and are often accompanied by complications and involve multiple organs.Multidrug-resistant CA-MRSA strains are prevalent in neonates.ST59-MRSA-SCCmecⅣa-t437 is the predominant clone causing neonatal invasive CA-MRSA infection.

ObjectiveTo investigate the incidence and risk factors in retinopathy of prematurity (ROP) at matched gestational age.Methods Data collected by the medical records of neonates from November 2007 to December 2010 in our neonatal database were analyzed.Patients'information was recorded from birth to discharge from NICU.Data included age after birth (hours),gestational age,body weight at birth,treatment,and maternal demographics.The statistical study was carried out by SPSS version 13.0 software.Mann - Whitney U test was used for numerate data.Fisher's exact probability test and Pearson's chi - square test were used to compare quantitative variables between independent groups.P values were considered significant when they were less than 0.05 ( two - sided).ResultsThe incidence of ROP was 5.38％.Gestational age of ROP group and control group was matched ( P =0.387 ),but difference in body weight at birth was significant ( P =0.045 ).Age after birth was significantly different ( P =0.013 ).Apnea and anemia were significantly different between two groups (P ＜ 0.01). The differences in duration of hospitalization,NCPAP and use of antibiotics between two groups were significant ( P ＜ 0.002,0.000 and 0.000,respectively).ROP group differed from control group greatly in hospitalization expenses.Multiple stepwise logistic regression analysis showed that oxygen supplenentation ( P =0.0237 ) and infection ( P =0.0118) were risk factors of ROP. ConclusionsThe incidence of ROP in NICU in Beijing Children's Hospital was 5.38％.Inhalation of oxygen supplementation and infection were risk factors of ROP.

Objective:To analyze the drug sensitivity of human lung adenocarcinoma stem cells (LASC) to cisplatin (DDP) and carboplatin (CBP). Methods:Human lung adenocarcinomaic cells SPC-A1,AG,and CPA-Y2 were treated with DDP and CBP. The cell viability of cells was detected by CCK-8 assay. The phenotypic characteristics of drug surviving cells(DSCs)were determined by immunofluorescence staining. The LASC population was then separated by magnetic-activated cell sorting method. The LASC in DSCs was traced by using green fluorescence protein (GFP). The drug sensitivity of DSCs to DDP and CBP was analyzed.Results:The LASC exhibited the phenotypes of bronchioalveolar stem cells (BASC, OCT4~+CCSP~+SP-C~+). After mixture of CD221~+LASC with CD221~-lung adenocarcinoma differentiated cells, the DSC population showed OCT4~+BASC phenotypes. These DSCs were significantly resistant to DDP and CBP.Conclusion:LASC has a high resistance to DDP and CBP. This may be the reason for tumor recurrence after chemotherapy.

OBJECTIVETo investigate the photocatalytic degradation of gaseous ammonia in static state by using nano-TiO2 as photocatalyst supported on latex paint film under UV-irradiation.

METHODSExperiments were conducted to study the relationship between the initial concentration of ammonia and the degradation products competing to be adsorbed on catalyst surface. Degradation of ammonia and its products were detected by spectrophotometry and catalytic kinetic spectrophotometry, respectively.

RESULTSOn the one hand, TiO2 catalyst was excellent for degradation of ammonia, and the crystal phase of TiO2, anatase or rutile, had little effect on degradation of ammonia, but the conversion of ammonia grew with the increase of catalyst content. On the other hand, apparent rate constant and conversion of ammonia decreased with the increase of initial concentration of ammonia, and the photocatalytic degradation reaction followed a pseudo-first-order expression due to the evidence of linear correlation between -lnC/C0 vs. irradiation time t, but the relationship between initial concentration and the degradation products was not linear in low initial concentration.

CONCLUSIONWhether the photocatalytic degradation of ammonia in static state follows a first-order reaction depends on the initial ammonia concentration due to competition in adsorption between reactant and the degradation products.

Ammonia ; chemistry ; Catalysis ; Gases ; Kinetics ; Metal Nanoparticles ; Microscopy, Electron, Transmission ; Paint ; Photochemistry ; Titanium ; chemistry

Objective:To observe the recent effects and toxicity of thermochemotherapy on malignant hydrothorax or hydroperitoneum,to evaluate the changes of the immunological functions,and to investigate the mechanism of thermochemotherapy.Methods:Fifty-two patients were treated with weekly intracavitary chemotherapy,and then combined with local endogenetic thermotherapy twice a week.As the control,another 50 patients received weekly intracavitary chemotherapy.The treatment lasted for two weeks and was followed by one-week rest,and then the recent effects and toxicity were observed.The T cell subset,NK cells and VEGF levels in serum,hydrothorax or hydroperitoneum were tested.Results:Overall response rates of the malignant hydrothorax were 86.9% vs 60.0%(P

OBJECTIVETo study a kind of surgical instrument for the treatment of ankle fractures in elderly patients.

METHODSFrom October 2007 to May 2009, 14 patients (9 males and 5 females,ranging in age from 58 to 81 years, averaged 69.3 years) with ankle joint fractures of type A and B were treated with modified 1/3 tubular plate combined with lag screws. According to the Danis-Weber classification, 6 patients were type A and 8 patients were type B. The AOFAS criteria was used to evaluate clinical effects.

RESULTSAll the patients were followed up ranged from 12 to 18 months and healed. The time of union of fractures ranged from 10 to 16 weeks. According to the clinical assess standard of AOFAS, the average score was 88.0 +/- 2.1.

CONCLUSIONIt is one of good choices to use modified 1/3 tubular plate and lag screws to treat ankle joint fractures in elder patients.

Aged ; Aged, 80 and over ; Ankle Injuries ; surgery ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo evaluate the feasibility and efficacy of intraperitoneal chemotherapy for malignant ascites caused by different types of abdominal cancers guided by chemo-sensitivity methyl tetrojolium coloremetric (MTT) assay in vitro.

METHODSCancer cells in the malignant ascites were collected for MTT assay to determine the chemo-sensitivity. The drug producing the highest or the second highest inhibition rate was selected for intraperitoneal chemotherapy. The correlation between the results of MTT assay and the response of malignant ascites, the clinical features, Karnofsky performance score (KPS) and prognosis were analyzed.

RESULTSMTT assay indicated that Taxotere (TXT) and Hydroxycamptothecin (HCPT) were the most effective to cancer cells in malignant ascites, and HCPT was mostly frequently used for intraperitoneal chemotherapy (56.9%). Twenty-four patients showed response by intraperitoneal chemotherapy (complete response: 7; partial response: 17) with a slightly significant correlation between the results of MTT assay and response of malignant ascites (P = 0. 014). The KPS of the responders was improved significantly (P < 0.001), and the response of malignant ascites to intraperitoneal chemotherapy was demostrated as an independent prognostic factor by multi-variate analysis in this series.

CONCLUSIONIn vitro chemo-sensitivity MTT assay guided intraperitoneal chemotherapy for malignant ascites is simple, effective and safe, which can improve the KPS and prognosis of the responders.

Adenocarcinoma ; drug therapy ; pathology ; Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; pharmacology ; therapeutic use ; Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacology ; therapeutic use ; Ascites ; drug therapy ; pathology ; Camptothecin ; administration & dosage ; analogs & derivatives ; pharmacology ; therapeutic use ; Cell Survival ; drug effects ; Colorectal Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Injections, Intraperitoneal ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreatic Neoplasms ; drug therapy ; pathology ; Stomach Neoplasms ; drug therapy ; pathology ; Taxoids ; administration & dosage ; pharmacology ; therapeutic use ; Tumor Cells, Cultured

Objective: To investigate the clinical, biochemical and genetic features of four carnitine-acylcarnitine translocase deficiency cases. Methods: Four cases diagnosed with carnitine-acylcarnitine translocase deficiency from Guangxi Maternal and Child Health Hospital were studied. DNA was extracted from dry blood filter for gene analysis. SLC25A20 gene analysis was performed in 1 case and the whole exon sequence analysis was performed in 3 cases. Results: Retrospective study on unrelated carnitine-acylcarnitine translocase deficiency patients, the age of onset was 1-28 d, the age of death were 1.5-30 d, main clinical features were hypoglycemia (4 cases), arrhythmia (2 cases), sudden death (2 cases). Biochemical test showed hypoglycemia (1.2-2.0 mmol/L) , elevated creatine kinase (955-8 361 U/L) and creatine kinase isozyme(199-360 U/L), normal or decreased free carnitine level (3.70-27.07 μmol/L) , elevated long-chain acylcarnitine (palmityl carnitine 1.85-14.84 μmol/L). The gene tests showed that all 4 cases carried SLC25A20 gene c.199-10T> G homozygous mutation, inherited from their parents. By analyzing the haplotype, we found that the mutation loci of C. 199-10T> G were all in the same haplotype. Conclusion The c.199-10T> G mutation is an important molecular cause of carnitine-acylcarnitine translocase deficiency, which has relatively high frequency in Guangxi population, and is related to the founder effect.

Objective:To investigate the predictive value of clinical radiomics model based on nnU-Net for the prognosis of gallbladder carcinoma (GBC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 168 patients who underwent curative-intent radical resection of GBC in the First Affiliated Hospital of Xi'an Jiaotong University from January 2012 to December 2020 were collected. There were 61 males and 107 females, aged (64±11)years. All the 168 patients who underwent preoperative enhanced computed tomography (CT) examina-tion were randomly divided into 126 cases in training set and 42 cases in test set according to the ratio of 3:1 based on random number table. For the portal venous phase images, 2 radiologists manually delineated the region of interest (ROI), and constructed a nnU-net model to automatically segment the images. The 5-fold cross-validation and Dice similarity coefficient were used to evaluate the generalization ability and predictive performance of the nnU-net model. The Python software (version 3.7.10) and Pyradiomics toolkit (version 3.0.1) were used to extract the radiomics features, the R software (version 4.1.1) was used to screen the radiomics features, and the variance method, Pearson correlation analysis, one-way COX analysis and random survival forest model were used to screen important radiomics features and calculate the Radiomics score (Radscore). X-tile software (version 3.6.1) was used to determine the best cut-off value of Radscore, and COX proportional hazard regression model was used to analyze the independent factors affecting the prognosis of patients. The training set data were imported into R software (version 4.1.1) to construct a clinical radiomics nomogram model of survival prediction for GBC. Based on the Radscore and the independent clinical factors affecting the prognosis of patients, the Radscore risk model and the clinical model for predicting the survival of GBC were constructed respectively. The C-index, calibration plot and decision curve analysis were used to evaluate the predictive ability of different survival prediction models for GBC. Observation indicators: (1) segmentation results of portal venous phase images in CT examination of GBC; (2) radiomic feature screening and Radscore calculation; (3) prognostic factors analysis of patients after curative-intent radical resection of GBC; (4) construction and evaluation of different survival prediction models for GBC. Measurement data with normal distribution were represented by Mean± SD. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate and multivariate analyses were performed using the COX proportional hazard regression model. The postoperative overall survival rate was calculated by the life table method. Results:(1) Segmentation results of portal venous phase images in CT examination of GBC: the Dice similarity coefficient of the ROI based on the manual segmentation and nnU-Net segmentation models was 0.92±0.08 in the training set and 0.74±0.15 in the test set, respectively. (2) Radiomic feature screening and Radscore calculation: 1 502 radiomics features were finally extracted from 168 patients. A total of 13 radiomic features (3 shape features and 10 high-order features) were screened by the variance method, Pearson correlation analysis, one-way COX analysis and random survival forest model. Results of random survival forest model analysis and X-tile software analysis showed that the best cut-off values of the Radscore were 6.68 and 25.01. A total of 126 patients in the training set were divided into 41 cases of low-risk (≤6.68), 72 cases of intermediate-risk (>6.68 and <25.01), and 13 cases of high-risk (≥25.01). (3) Prognostic factors analysis of patients after curative-intent radical resection of GBC: the 1-, 2-, and 3-year overall survival rates of 168 patients were 75.8%, 54.9% and 45.7%, respectively. The results of univariate analysis showed that preopera-tive jaundice, serum CA19-9 level, Radscore risk (medium risk and high risk), extent of surgical resection, pathological T staging, pathological N staging, tumor differentiation degree (moderate differentiation and low differentiation) were related factors affecting prognosis of patients in the training set ( hazard ratio=3.28, 3.00, 3.78, 6.34, 4.48, 6.43, 3.35, 7.44, 15.11, 95% confidence interval as 1.91?5.63, 1.76?5.13, 1.76?8.09, 2.49?16.17, 2.30?8.70, 1.57?26.36, 1.96?5.73, 1.02?54.55, 2.04?112.05, P<0.05). Results of multivariate analysis showed that preoperative jaundice, serum CA19-9 level, Radscore risk as high risk and pathological N staging were independent influencing factors for prognosis of patients in the training set ( hazard ratio=2.22, 2.02, 2.89, 2.07, 95% confidence interval as 1.20?4.11, 1.11?3.68, 1.04?8.01, 1.15?3.73, P<0.05). (4) Construction and evaluation of different survival prediction models for GBC. Clinical radiomics model, Radscore risk model and clinical model were established based on the independent influencing factors for prognosis, the C-index of which was 0.775, 0.651 and 0.747 in the training set, and 0.759, 0.633, 0.739 in the test set, respectively. The calibration plots showed that the Radscore risk model, clinical model and clinical radiomics model had good predictive ability for prognosis of patients. The decision curve analysis showed that the prognostic predictive ability of the clinical radiomics model was better than that of the Radscore risk and clinical models. Conclusion:The clinical radiomics model based on the nnU-Net has a good predictive performance for prognosis of GBC.