Objective To explore the clinical characteristics and diagnosis of mycoplasma pneumoniae(MP) pneumonia showing lobar pneumonia.Methods Patients from Jan.2004 to Dec.2005 were selected as researching case,which had samptoms and signs of respiratory in clinic,the chest Xray shown lobar pneumonia,the MP of down respiratory′s secretion detected by polymerase chain reaction(PCR) and MP-IgM of serum detected by indirect hemagglutination were positive.The clinical data of them were reviewed.Results MP pneumonia showing lobar pneumonia was same to streptococcus pneumoniae pneumonia in clinic,but it had some characters:1.majority of the lobar MP pneumonia were children being student;2.the process was long,the samptoms of respiratory was tipical,the continuous fever was few,and the infectious samptoms was not obvious as streptococcus pneumoniae pneumonia;3.the injury to lung was more and tipical;4.the increase of white blood cell,neutrocyte and C-reactive protein were not clearly as to streptococcus pneumoniae pneumonia,but the absorbing of lung′s focal was relatively fast;5.the ?-lactams antibiotic was not effective,but macrolides was effective.Conclusions Clinical characters of MP pneumonia are needed to master,the variety of chest X-ray changes and differentiate from other pneumonia infected by other are needed to notice.

Objective To study the diagnosis and treatment of renal cell carcinoma. Methods 369 cases of renal cell carcinoma were reviewed for their incidence,diagnosis,treatment and prognosis. Results 281 cases(76.2%) were clear cell carcinoma ,39 cases (10.6%) of granular cell carcinoma,42 cases(11.4%) being a combination of the above two varieties and 7 cases being of other cell types. Radical nephrectomy was performed for 301 cases (81.6%) and other procedures for 45 cases. 297 cases have been followed up:three-year,five-year and ten-year survival rates were 74.6%、56.2% and 28.2% respectively. Conclusions B type ultrasonography and computerized tomography (CT) are important means in the diagnosis of renal cell carcinoma.The most effective treatment is radical nephrectomy at early stage,wherea sbiological treatment works in certain degree.

0.05).The HBeAg-turned-to-negative rate was 57% in the treated group and 38.8% in the control group.The HBVDNA-turned-to-negative rate was 59.3% in the treated group and 42.4% in the control group (P

OBJECTIVETo evaluate the effects of Attractin (Atrn) silence on the anti-oxidative and anti-apoptotic abilities of TM4 Sertoli cells and its influence on the expressions of superoxide dismutase (SOD) and caspase6 in the cells.

METHODSWe observed the apoptotic indexes of TM4 Sertoli cells with normal expression (control), partial deletion, and complete deletion of the Atrn gene (psiRNA-TM4, psiAtrn-TM4, and mu-SC). We determined the mRNA and protein expressions of SOD and caspase6 by Q-PCR and Western blot, measured the SOD activity and malondialdehyde (MDA) contentby spectrophotometry, and detected the apoptotic index of the cells by TUNEL.

RESULTSCompared with psiRNA-TM4, after inhibition of the Atrn expression, the Sertoli cells in the psiAtrn-TM4 and mu-SCgroups showed significantly decreased expressions ofSOD mRNA (70.76% and 92.58%) and protein (65.11% and 71.0%) (both P < 0.05). The levels of caspase 6 mRNA and protein were increased 5.28 and 3.40 times in the psiAtrn-TM4 and 2.97 and 2.50 times in the mu-SCgroup as compared with the normal control (both P < 0.05). Atrn deletion markedly increased the apoptotic indexes of the cells in the psiAtrn-TM4 and mu-SC groups by 16.22% and 22.03% (P < 0.05) and reduced the activity of SOD by 23.00% and 39.37% (P < 0.05); it also elevated the level of MDA by 155.22% (P < 0.05).

CONCLUSIONThe Atrn gene exerts influence on the function of Sertoli cells in multiple ways, in which antioxidative stress and apoptosis regulation may play an important role.

Animals ; Apoptosis ; Caspase 6 ; metabolism ; Cells, Cultured ; Gene Deletion ; Male ; Membrane Proteins ; genetics ; metabolism ; Mice ; Oxidative Stress ; Sertoli Cells ; metabolism ; pathology ; Superoxide Dismutase ; metabolism

Objective To evaluate the diagnostic value of T-cell enzyme-linked immunosorbent spot assay (T-SPOT.TB) using both pleural effusion and peripheral blood in tuberculous pleurisy.Methods One hundred and two cases of in patients with pleural effusion treated in Anhui Chest Hospital from January 2014 to October 2015 were enrolled in this study.T-SPOT.TB was performed using both serous effusion mononuclear cells (SEMC) and peripheral blood mononuclear cells (PBMC),and the diagnostic sensitivity and specificity were calculated.Chi square test was used for categorical variables and MannWhitney U test was used for continuous variables in non-normal distribution.Results Of the 102 participants,71 (69.61 ％) were microbiologically or clinically diagnosed with tuberculous pleurisy and 31 (30.39 ％) were diagnosed with other diseases.In tuberculous pleurisy group,the median spot forming cells (SFC) of T-SPOT.TB for early secretory antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) using SEMC were 159/2.5 × 105 (120/2.5 × 105-200/2.5× 105) and 160/2.5 × 105 (110/2.5 × 105-210/2.5 × 105),respectively;and the median SFC of T-SPOT.TB using PBMC were 30/2.5×105 (15/2.5×105-55/2.5×105) and 40/2.5×105(8/2.5×105-87/2.5 ×105),respectively.The SFC counts of SEMC were obviously higher than those of PBMC,and differences were statistically significant (for ESAT-6,Z=-7.818;for CFP-10,Z=-7.120,both P＜0.05).The ROC curve analysis showed that using a cut-off value of 38 SFC per 2.5 × 105 SEMC,the area under the curve is 0.969.The sensitivity and specificity of T-SPOT.TB using PBMC were 90.14％ and 77.42％,respectively;and those of T-SPOT.TB using SEMC were 95.77％ and 93.55％,respectively.When combined the T-SPOT.TB assay using both PBMC (≥6 spots) and SEMC (≥38 spots),the sensitivity and specificity were 90.14％ and 96.77％,respectively.Conclusion The joint detection of T-SPOT.TB using both PBMC and SEMC can be an effective diagnostic method for tuberculous pleurisy.

Objective To investigate the relationship between IgG antibody titer in pregnant women with maternal-fetal ABO blood incompatibility and hemolytic disease of fetuses and newborns.Methods From January 31 2009 to January 31 2010,1269 singleton pregnant women who were suspected to have maternal fetal ABO blood incompatibility in Department of Obstetrics and Gynecology,Southwest Hospital,Third Military University were collected.Anti-A or anti-B IgG titers of them were detected at 28-30 gestational age,and umbilical cord blood were taken when delivery and hemolytic disease of the newborn serological test were done to diagnose hemolytic disease of the newborn (HDN).The relationship between the titers and incidence of fetal or neonatal hemolytic disease was retrospectively analyzed by Kendall tau rank correlation.Results No IgG of anti-A or anti-B in serum were found in 58.4％ (741/1269) pregnant women,while the antibody titer of 5.1％ (65/1269) pregnant women were more than or equal to 1 ∶ 128.When they were tested again at 36 gestational week,the titer of 17 cases increased twice but lower than 1 ∶ 512.No signs of intrauterine hemolysis,such as edema,ascites and pleural effusion,were found.Three hundred and eighty neonates (29.9％,380/1269) were diagnosed as HDN.Among which,12 cases (3.2％,12/380) showed mild anemia and (or) jaundice within 24 hours after delivery.There was positive correlation between incidence of neonatal hemolysis and antibody titer(Tb=-0.293,P＜0.01).The incidence of HDN increased from 85.4％ (35/41) in women with antibody titer of 1 ∶ 128 to 5/5 inwomen with antibody titer at 1 ∶ 512 (x2=108.906,P＜0.01).Among 380 HDN neonates,322 cases were transferred to neonatal intensive care unit for phototherapy based comprehensive therapy,and two underwent exchange transfusion.All patients were cured.Conclusions The intrauterine hemolysis incidence of patients with suspected maternal-fetal ABO blood incompatibility is very low,and no special care is required during pregnancy.Anti-A or anti-B tests during pregnancy is helpful in early diagnosis and management of HDN.

Objective To discuss basis and operative indications for anterior reversional indication after failures of posterior pedicel screw instrumentation for thorcolumbar burst fracture combined with paraplegia.Methods Clinical data of 21 cases who had failures of posterior pedical screw fixation because of thorcolumbar burst fracture combined with paraplegia were analyzed retrospectively from February 1999 to April 2005.All cases were operated by removing posterior screw device.Meanwhile,one stage anterior cord decompression,correction of kyphosis,fusion with self-ilium or Titanium cage with granule fractured vertebrate and internal fixation was carried out according to clinical symptom and image findings.Spinal cord function and correction of kyphosis were evaluated by Frankel score and Cob angle.Results All cases were operated successfully.After operation,there was rib nerve injury occurred in two cases,leakage of CSF in three and refractory thigh pain in two.The follow up ranging from three months to six years(average 2.2 years) showed good interfixation except for one case had breakage of screw four months after operation.Cob angle of kyphosis recovered from preoperative 16.4? to 5.2??0.3? at follow up.Of all,16 cases had partly recovery of spinal cord function according to Frankel score.(Conclusion)As for thoracolumbar burst fracture combined with paraplegia,anterior approach can attain direct decompression,satisfactory correction of kyphosis and stable fixation and is suitable for most cases.

Ectodermal Dysplasia ; classification ; diagnosis ; Humans ; Infant ; Male ; Patient Care

Objective:To analyze the clinical features and genetic factors of neonatal 17β-hydroxysteroid dehydrogenase type10 (HSD10) deficiency.Methods:The clinical characteristics and genetic test results of a child with HSD10 deficiency coming from Children′s Hospital of Nanjing Medical University in April 2019 were retrospectively analyzed.The keywords" 17β-hydroxysteroid dehydrogenase type 10 deficiency" or " 2-Methyl3-Hydroxybutyryl-CoA dehydrogenase deficiency" or " HSD10" , etc.were searched in various databases, including CNKI, Wanfang, Weipu, Embase and PubMed to review the cases collected from all published data until May 31, 2020.Results:The patient was a newborn male who developed symptoms on the first day after birth.The main signs were metabolic acidosis, increased blood ammonia and lactate, and hypotonia.Trio whole exom sequencing in the patient and his parents identified hemizygous NM001037811: c.650G>A, p.R217Q in the HSD17B10 gene that is inherited from the mother.Since the child died on the third day after birth, no further central nervous system examination was performed.The mother of the child has intellectual disability, the sibling sister is normal and the HSD17B10 locus is wild type.By lite-rature reviewing, 5 newborn cases with clear medical records and genetic test results were listed.All patients were male, and had onset of HSD10 deficiency within 1 week after birth.The main phenotypes include metabolic acidosis (increased blood ammonia and lactate), hypoglycemia, hypotonia, and convulsions.All 6 children died in early infancy.The corresponsive HSD17B10 variants were c. 740A>G/p.N247S, c.677G>A/p.R226Q, c.257A>G/p.D86G and c. 650G>A/p.R217Q, which did not indicate the hot spots of mutation. Conclusions:HSD10 deficiency in the neonatal period is relatively rare.The clinical diagnosis is difficult due to the serious condition and short course of the disease.Severe metabolic acidosis, hypotonia, and convulsions in neonatal patients are the main reasons for the poor prognosis, which can be attributed to the hemizygous variation and heterogeneity of the mutation site in male patients.c.650G>A may be closely associated with severe neonatal HSD10 deficiency, but the molecular biological mechanism needs to be further clarified.HSD10 deficiency has a poor prognosis and lacks effective treatment.

Objective:To investigate the expression of solute carrier family 35 member E1 (SLC35E1) and SLC35E2B in skin lesions of patients with Mycobacterium infections. Methods:Paraffin-embedded skin tissues of 31 patients confirmedly diagnosed with Mycobacterium infections were collected from Dermatology Hospital of Southern Medical University from 2014 to 2018, including 10 cases of multibacillary leprosy, 9 of nontuberculous mycobacterial infection, 7 of cutaneous tuberculosis, and 5 of erythema induratum. Meanwhile, paraffin-embedded skin tissues of 10 healthy individuals were collected, and served as normal control group. Immunohistochemical staining was performed to determine the expression of SLC35E1 and SLC35E2B in the lesional and normal control skin specimens, and immunofluorescence staining to observe the co-expression of CD68 and S100 with SLC35E1 and SLC35E2B in the skin lesions. Results:Neither SLC35E1 nor SLC35E2B was expressed in the normal control group, but high expression of SLC35E1 and SLC35E2B was observed in the dermis of skin lesions from the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis or erythema induratum. Immunohistochemical staining showed that the expression of SLC35E1 and SLC35E2B (expressed as average optical density) was significantly higher in the multibacillary leprosy group (0.143 ± 0.010, 0.169 ± 0.004, respectively) , nontuberculous mycobacterial infection group (0.278 ± 0.015, 0.229 ± 0.088, respectively) , cutaneous tuberculosis group (0.171 ± 0.010, 0.103 ± 0.016, respectively) and erythema induratum group (0.200 ± 0.015, 0.118 ± 0.021, respectively) than in the normal control group (both 0, all P < 0.05) . Immunofluorescence staining showed co-expression of SLC35E1 and SLC35E2B with CD68 in skin lesions of the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis. Conclusion:Both SLC35E1 and SLCE2B were markedly highly expressed in skin lesions of patients with Mycobacterium infections.