Objective To explore the possibility of breast feeding in chronic asymptomatic hepatitis B virus (HBV) carriers after immuno prophylaxis of the infants. Methods The infants with asymptomatic HBV carriers mothers were selected by the obstetric department of Qilu Hospital of Shangdong University, Jinan Maternity and Infant Health Institute of Shangdong from Sept 2001 to Oct 2003 prospectively. Umbilical blood HBV deoxyribonucleic acid (HBV DNA) was detected at birth. All infants received 200 IU HBV specific immunoglobin(HBIG)within 12 hours and on 14 days after birth. The hepatitis B recombinant vaccine was given within 24 hours after birth and at 1 and 6 months of age. The way of feeding was chosen by the mothers as they liked. There were 55 infants in breast feeding group and 36 in bottle feeding group. Infants were then followed up at 7 and 12 months of age and tested for hepatitis B surface antigen(HBsAg), hepatitis B surface antibody (anti HBs), hepatitis B e antigen(HBeAg), hepatitis B e antibody(anti HBe) and hepatitis B core antibody(anti HBc) and HBV DNA. Uninfected infants with negative anti HBs were given repeated dose of vaccinations. Results At 7 and 12 months of age, the positive rates of HBV DNA were 9.09%(5/55)and 9.09%(5/55), anti HBs were 85.45%(47/55)and 90.90%(50/55)in breast feeding group respectively;while the positive rates of HBV DNA were 8.33%(3/36)and 8.33%(3/36), anti HBs were 86.11%(31/36)and 91.67%(33/36)in bottle feeding group respectively. No significant differences was shown in positive rates of HBV DNA and anti HBs between these two groups. Conclusions With appropriate immunoprophylaxis, including hepatitis B immune globulin and hepatitis B vaccine, HBV carriers can breast feed their babies.

Objective To investigate prenatal diagnosis and treatment of toxoplasmosis in fetuses with fluorescence quantitative polymerase chain reaction (FQ PCR) technique Methods Of the 70 pregnant women with toxoplasma(TOX) DNA positive , TOX DNA in amniotic fluid and/or fetal umbilical cord blood was detected with FQ PCR technique to diagnose fetal infection 48 ones were given routine treatment with spiramycin for 2 therapy periods Ultrasound examination were undertaken in all of pregnant women to monitor fetal growth Results Of the 70 cases with TOX DNA positive, TOX DNA was detected in 21 fetuses TOX DNA positive rates were similar in amniotic fluid and umbilical cord blood The higher the TOX DNA, the higher fetal infectious rate Fetal infectious rate was lower in treatment group(21%) than that in control group (50%), there was a statistically difference between two groups Conclusions Maternal TOX infection may cause fetal damage Detection of TOX DNA in amniotic fluid with FQ PCR technique can diagnose fetal toxoplasmosis exactly Treatment in pregnant period may decrease intrauterine infection rate

Objective To investigate the impact of overweight on the prognosis of patients with acute mild ischemic stroke or moderate-high risk transient ischemic attack(TIA).Methods A total of 366 patients with acute mild ischemic stroke or moderate-high risk TIA who carried CYP2C19 loss-of-function alleles were included in the study.Baseline data were collected at admission,and clinical outcomes were collected within 3 months post-onset(primary outcomes:stroke recurrences within 3 months post-onset;secondary outcomes:composite outcome of stroke recurrence or death within 3 months post-onset,vascular events,and quality of life within 3 months).Kaplan-Meier method was used to plot the cumulative incidence curve of outcomes.Multivariate Cox proportional hazards mod-el and multivariate Logistic regression model were used to evaluate the relationship between over-weight and clinical outcomes within 3 months post-onset in patientswith ischemic stroke or TIA.The integrated discrimination improvement index(IDI)and net reclassification improvement index(NRI)were calculated to assess the predictive value of adding body mass index(BMI,whether o-verweight or not)based on traditional models for predicting the prognosis of acute ischemic stroke or TIA.Results After 3 months of follow-up,28 patients had stroke recurrence,1 patient died,and 31 patients had vascular events.The Kaplan-Meier cumulative incidence curve showed that the cu-mulative incidences of stroke recurrence,stroke recurrence or death,and vascular events after 3 months of onset were lower in overweight patients compared with non-overweight patients(Log-rank P＜0.05).Multivariate analysis showed that compared with non-overweight patients,overweight pa-tients had significantly reduced risks of stroke recurrence within 3 months(HR=0.24;95％CI,0.08 to 0.71),composite outcome of stroke recurrence or death(HR=0.24;95％CI,0.08 to 0.69),and vascular events(HR=0.22;95％CI,0.07 to 0.63),and significantly improved qual-ity of life within 3 months(OR=0.39;95％CI,0.20 to 0.76).The IDI and NRI calculations showed that compared with traditional models,the new model adding BMI(whether overweight)had significantly improved predictive ability for the prognosis of acute ischemic stroke or TIA.Conclu-sion Overweight may be a protective factor for the prognosis of TIA patients with acute mild ische-mic stroke or moderate-high risk who carry CYP2C19 loss-of-function alleles.Compared with non-o-verweight patients,overweight patients have reduced risks of stroke recurrence,composite outcome of stroke recurrence or death,and vascular events within 3 months post-onset,and improved quality of life within 3 months post-onset.

Objective To investigate the impact of overweight on the prognosis of patients with acute mild ischemic stroke or moderate-high risk transient ischemic attack(TIA).Methods A total of 366 patients with acute mild ischemic stroke or moderate-high risk TIA who carried CYP2C19 loss-of-function alleles were included in the study.Baseline data were collected at admission,and clinical outcomes were collected within 3 months post-onset(primary outcomes:stroke recurrences within 3 months post-onset;secondary outcomes:composite outcome of stroke recurrence or death within 3 months post-onset,vascular events,and quality of life within 3 months).Kaplan-Meier method was used to plot the cumulative incidence curve of outcomes.Multivariate Cox proportional hazards mod-el and multivariate Logistic regression model were used to evaluate the relationship between over-weight and clinical outcomes within 3 months post-onset in patientswith ischemic stroke or TIA.The integrated discrimination improvement index(IDI)and net reclassification improvement index(NRI)were calculated to assess the predictive value of adding body mass index(BMI,whether o-verweight or not)based on traditional models for predicting the prognosis of acute ischemic stroke or TIA.Results After 3 months of follow-up,28 patients had stroke recurrence,1 patient died,and 31 patients had vascular events.The Kaplan-Meier cumulative incidence curve showed that the cu-mulative incidences of stroke recurrence,stroke recurrence or death,and vascular events after 3 months of onset were lower in overweight patients compared with non-overweight patients(Log-rank P＜0.05).Multivariate analysis showed that compared with non-overweight patients,overweight pa-tients had significantly reduced risks of stroke recurrence within 3 months(HR=0.24;95％CI,0.08 to 0.71),composite outcome of stroke recurrence or death(HR=0.24;95％CI,0.08 to 0.69),and vascular events(HR=0.22;95％CI,0.07 to 0.63),and significantly improved qual-ity of life within 3 months(OR=0.39;95％CI,0.20 to 0.76).The IDI and NRI calculations showed that compared with traditional models,the new model adding BMI(whether overweight)had significantly improved predictive ability for the prognosis of acute ischemic stroke or TIA.Conclu-sion Overweight may be a protective factor for the prognosis of TIA patients with acute mild ische-mic stroke or moderate-high risk who carry CYP2C19 loss-of-function alleles.Compared with non-o-verweight patients,overweight patients have reduced risks of stroke recurrence,composite outcome of stroke recurrence or death,and vascular events within 3 months post-onset,and improved quality of life within 3 months post-onset.

Objective:To compare and explore the diagnostic performance of adding value of transabdominal and transvaginal contrast-enhanced ultrasound (CEUS) to Ovarian-Adnexal Reporting and Data System (O-RADS US) risk stratification and management system in differential diagnosis of adnexal masses.Methods:A total of 180 adnexal masses with solid components in 175 women were enrolled retrospectively between September 2021 and November 2022. All patients underwent routine Doppler ultrasound examinations and CEUS examinations. Among these masses, 107 masses underwent with transabdominal CEUS, 58 masses underwent with transvaginal CEUS, and 15 masses underwent both transvaginal and transabdominal CEUS. All patients were scheduled for surgery and pathological results served as the reference standard. Routine Doppler ultrasound and CEUS images and video were reviewed by a subspecialty radiologist using Vuebox software. The O-RADS US was downgraded or upgraded according to the CEUS characteristics of the masses. The diagnostic accuracy was assessed using ROC curve analysis. The area under the ROC curve (AUC) was calculated to compare the diagnostic performance of adding value of transabdominal and transvaginal CEUS to O-RADS US.Results:The diagnostic performance of adding transabdominal and transvaginal CEUS to O-RADS US were both significantly higher than of O-RADS US alone (transabdominal CEUS: AUC 0.83 vs 0.76, P=0.018; transvaginal CEUS: AUC 0.92 vs 0.81, P=0.013). Combination of transvaginal CEUS and O-RADS US was superior to that of combination of transabdominal and O-RADS US in the differential diagnosis of adnexal masses ( P=0.047). When the maximal diameter of adnexal masses ≤40 mm, transabdominal combined with O-RADS US presented the lowest diagnostic performance, with an AUC of 0.73. Conclusions:Combination of transvaginal CEUS and O-RADS US was superior to that of combination of transabdominal and O-RADS US in assessing adnexal masses with solid components. When the maximal diameter of adnexal masses ≤40 mm, transvaginal CEUS examination was recommended.