Objective To study the clinical and imaging features of neonatal acute osteomyelitis.Method From 2011 to 2016,the clinical feature,laboratory results,pathogen,imaging features,treatment and prognosis of neonates who were diagnosed with acute osteomyelitis in NICU of People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively studied.Result A total of 13 cases were enrolled during the study period,5 males and 8 females,with onset age of 7 ～30 d.8 cases had different degrees of fever and 5 of them showed dyspnea;8 cases had elevated skin temperature and swelling at the affected area;7 cases presented with irritability;6 cases had anorexia;all cases had elevated white blood cell count.Blood culture were taken immediately after their admission,and culture from the pus were taken for some patients.5 cases had positive blood culture and Staphylococcus aureus was the main pathogen.6 cases had positive pus culture,and 4 cases showed gram positive (G +) bacteria and 2 cases gram negative (G-) bacteria.Humerus and tibia were the main foci of the infection.4 cases had X-ray examination within 7 days of onset showing soft tissue swelling and no sign of bone destruction.13 cases had X-ray examination at 7 to 14 days of disease.Among them only 1 case showed soft tissue swelling,and the rest 12 cases had different levels of bone destruction and periosteal reaction.2 cases had X-ray examination after 14 days of disease,showing stiffening ring,inflammatory changes and periosteal reaction.All patients were treated with broad-spectrum antibiotics after admission,and the affected limbs were immobilized.3 cases had further surgical treatment.11 patients recovered and were discharged,1 patient was treated at local hospital after diagnosis and 1 patient refused further treatment due to serious complications after 35 d of hospital stay and was lost on follow-up.Conclusion The clinical manifestation of neonatal osteomyelitis is atypical,the radiological and pathogen examination should be carried out once osteomyelitis is suspected.Appropriate antibiotics and timely surgery can prevent further damage and long-term sequela.

Aged ; Anthracosis ; physiopathology ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Ventilation ; Respiratory Function Tests

Near infrared spectroscopy ( NIRS) is capable of determining water contents in oils. However, too much moisture contents in the oils will scatter rather than absorb the NIRS. This may cause greater measurement error. For this reason, a nonionic surfactant (Span-80) was screened to make the water in the oils evenly dispersed into small droplets. The NIRS analysis was subsequently employed to build support vector regression ( SVR ) model of the water content. In this experiments, the upper limit of the water content determination was improved from the conventional 0. 1% to 1. 0% ( V/V) by the oil-water stabilization. Applying successive projection algorithm, 15 valid variables (2. 9% of the original ones) from 511 NIRS variables were selected. With the proposed SVR model, the measurement precision criteria for the validation dataset were root mean squares error percentage 2 . 93%, correlation coefficient 0 . 9944 , and relative percent derivation 9 . 4732%.

Pancreatic ductal carcinoma accounts for 85％-90％ in pancreatic cancer, followed by the pancreatic cellendocrine tumors and pancreatic acinar cell carcinoma.In addition, mesenchymal cell carcinoma of pancreas is rare, and a mixed pancreatic cancer from 3 cells carcinoma is extremely rare.And pancreatic cancer always assume hypovascular tumor,spontaneous rupture of pancreatic cancer is rarely reported.A patient with a mixed duct-acinar-islet cell tumor of pancreas was admitted to the Second Affiliated Hospital of Harbin Medical University in June 2014, and underwent emergent operation of intraabdominal bleeding due to spontaneous rupture of tumor.The follow-up was done up to January 20, 2015.The patient died of intraabdominal widespread implantation metastasis of pancreatic cancer.A mixed duct-acinar-islet cell tumor of pancreas is extremely rare and easy to metastasis and diffusion of tumor with a rapid disease progression and a poor prognosis of patient,while operation is the key to terminate deterioration of the condition, and is the last line of defense to save lives.

Objective To analyze the reasons of catheter fracture of implantable vascular access devices and to explore the prevention and handling measures. Methods A retrospective analysis was carried in 3 887 adult patients with implantable vascular access devices and 13 had catheter fracture. The clinical features and causes were analyzed and the successful handling measures were summarized. Results Of 3 887 cases, a total of 13 (0.33%) catheter fracture occurred. The incidence rate of catheter fracture via subclavian jugular venipuncture was 3.70%,(6/162) , via internal jugular venipuncture was 0.18% (7/3 725), via internal jugular venipuncture was significantly lower than that via the subclavian venipuncture (χ2=47.505,P=0.000). There had no statistical differences between the left and right of the two puncture ways(P=0.707,0.682). Conclusions Catheter fracture is one of the serious complications in the process of use and maintenance of implantable vascular access device. Choosing appropriate surgical method, strengthen maintenance education, specificating the operation procedure, closing observation and other measures can not only reduce the occurrence of the catheter fracture, but also can dealt with catheter fracture in time, which could ensure the safety of patients' life.

Objective To investigate the effects of repeated neonatal administration of dizocipline maleate (MK-801), the N-methyl-D-aspartate (NMDA) receptor antagonist, on the expression of NMDA receptor subunits NMDAR 1 (NR1), NMDAR2A (NR2A), NMDAR2B (NR2B) and the protein levels of nerve growth factor (NGF) in neonatal rats. Methods Neonatal Sprague-Dawley (SD) rats were randomly divided into research group and control group, with 15 ani-mals in each group. Rats were administrated subcutaneously with MK-801 or normal saline from postnatal day (PND) 5 to PND14 (0.25 mg/kg, twice a day). The expression levels of NR1, NR2A, NR2B and NGF were examined on PND15, PND42 and PND70 in the prefrontal cortex and hippocampus. Results At PND15 (neonatal period), there were no signifi-cant differences in the expression levels of NR1, NR2A, NR2B and NGF in the prefrontal cortex and hippocampus be- tween the two groups (P>0.05). At PND42 (adolescence), NGF protein levels in the prefrontal cortex was significantly low-er in research group than in control group [(56.19±37.87) vs. (152.54±53.92), P<0.01]. At PND70 (adulthood), the expres-sion of NR1, NR2A in the hippocampus was significantly higher in research group than in control group [NR1:(149.55%± 27.00%) vs. (100.00%±32.08%);NR2A:(171.54%±19.85%) vs. (100.00%±51.04%). P<0.05]. Conclusion Neonatal re-peated treatment of MK-801 increases the expression of NMDA receptor subunits NR1, NR2A in the hippocampus in adulthood while decreases the expression of NGF in the prefrontal cortex in adolescence, suggesting that neonatal block-ade of the NMDA receptor may influence the growth and development of the nervous system.

A 16-year-old male presented with a 11-year history of progressively enlarging erythema and crusting on the right cheek.Physical examination revealed an irregularly shaped,sharply marginated,dark erythematous patch sized 6 cm x 10 cm and plaques with mild verrucous proliferation.There were strip-like scar at the margin of lesions and multiple ulcers measuring 0.5 to 1 cm in diameter with firm crusts.No small jellycolored nodules were observed.Direct microscopy of multiple scrapings under the crusts showed many light brown,septate,branching and irregular hyphae.Olivaceous-black woolly colonies grew at 25 C and 35 C on Sabouraud's dextrose agar and potato dextrose agar; flask-shaped conidiogenous cells with funnel-shaped collarettes and ellipsoidal conidia arranged in flower-like shape were observed microscopically.PAS staining showed numerous septate and branching hyphae,pseudohyphae and yeast-like cells.There was a 99.73％ similarity in the species-specific rDNA sequence between the isolate and phialophora verrucosa standard strain CDC-B2152.The patient was diagnosed with cutaneous phaeohyphomycosis caused by Phialophora verrucosa.The lesion subsided after treatment with amphotericin B and itraconazole,but recurred after drug withdrawal.Itraconazole and terbinafine were administered for the retreatment of this patient.

Objective:Primary gastric choriocarcinoma (PGC) is a rare tumor. This study aimed to analyze cases reported in Chi-nese and two cases in our hospital. This study was also conducted to investigate the clinical characteristics and treatment of PGC. Meth-ods:The Chinese Medical Current Contents and China Biology Medicine database was retrieved with the following terms:primary gas-tric choriocarcinoma, stomach choriocarcinoma, and ectopic choriocarcinoma. The clinical data in published literature were retrospec-tively analyzed. Two cases from our hospital were also retrospectively analyzed. Results:A total of 16 patients with PGC (14 case stud-ies and 2 cases from our hospital) were included in this study. The average age of the patients was 57.69 years (ranging from 42 years to 79 years). Among the 16 patients, 4 were females and 12 were males. The main clinical manifestation was abdominal discomfort (12/16). Laboratory and imaging tests were non-specific, but HCG-βin all of the patients increased (11/11). Organ or lymph node metasta-sis was found in 13 patients, including 6 cases in which two or more organs showed metastasis. These organs were primarily the liver, the stomach lymph nodes, the lungs, the brain, and the abdominal cavity. Pathological examination results showed that 12 of the 16 cas-es displayed ulcers with necrosis and hemorrhage. The four remaining cases manifested lesions. Lesions may occur in the stomach less-er curvature (5 cases), stomach sinus (6 cases), cardiac (2 cases), and gastric body (3 cases). The histological components of PGC co-ex-isted with other factors, such as adenocarcinoma (7 cases), adenocarcinoma and squamous (2 cases), adenocarcinoma and a signet ring cell (1 case), or pure choriocarcinoma (6 cases). Surgery combined with chemotherapy was the main treatment. A total of 14 patients un-derwent surgical operations. Among these patients seven underwent chemotherapy after surgery and one underwent chemotherapy. Among the 10 patients who were followed up, 8 died within six months after diagnosis. Conclusion:PGC is a rare stomach cancer with poor prognosis and primarily affects older men. No characteristic clinical manifestations were observed, but HCG-βas a specific serum tumor biomarker increased in all of the affected patients. Histological components co-existed with other stomach cancers. Surgical exci-sion combined with chemotherapy was the preferred treatment in early stages, and systemic chemotherapy was the recommended treat-ment in advanced stages.

Objective • To investigate the feasibility of four-dimensional flow MRI (4D flow MRI) in evaluating the hemodynamics of forearm autologous arteriovenous fistula (AVF) in renal dialysis patients. Methods • Forty-five patients from Renal Division of Renji Hospital, Shanghai Jiao Tong University School of Medicine were included. Patients with forearm AVF underwent ultrasonography and MRI. The consistency of 4D flow MRI hemodynamic parameters measured by two radiologists and hemodynamic parameters at the same plane of AVF by 4D flow MRI and ultrasonography were analyzed by paired t test. The morphological parameters of AVF were acquired from black blood sequence, and they were used for Pearson correlation analysis with the hemodynamic parameters obtained from 4D flow MRI. Results • Forty-two patients completed the forearm AVF ultrasonography and MRI successfully. Paired t test showed that the consistency of 4D flow MRI hemodynamic parameters by two radiologists was good (all P=0.000), and all hemodynamic parameters measured by 4D flow MRI and ultrasonography were in good agreement (r=0.292-0.569, all P<0.05) except for the peak flow velocity at anastomosis (r=-0.078, P>0.05). Pearson correlation analysis showed that the cephalic venous flow volume of AVF was correlated with the diameter ratio of the cephalic venous to radial artery and the anastomosis area ( r=-0.671, r=0.482, both P<0.05), and the wall shear stress (WSS) near the anastomosis was correlated with the anastomosis angle and wall thickness (r=0.530, r=0.462, both P<0.05). Conclusion • 4D flow MRI can be used to evaluate the hemodynamic parameters of forearm AVF in renal dialysis patients, which can provide a reference for further study of AVF dysfunction.

Objective: To learn the concentration of target genes of severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) and the influencing factors in the confirmed cases with coronavirus disease 2019 ( COVID-19 ) in Ningbo. Methods: Demographic information and clinical diagnosis of COVID-19 cases reported in Ningbo from January 21 to February 20, 2020 were collected through China Disease Control and Prevention Information System. The Ct values of ORF1ab and N of the cases were collected through Ningbo Center for Disease Control and Prevention and designated hospitals, and analyzed in terms of gender, age, severity, clinical classification, source of case, sampling time and specimen type. Results: There were 157 confirmed COVID-19 cases, including 56 males ( 35.67% ) and 101 females ( 64.33% ). Sixty-seven cases ( 42.68% ) aged between 40 and 60 years old. The Ct values of ORF1ab and N in females were 29.96±5.28 and 30.38±4.90, which were higher than 27.56±4.94 and 28.03±4.88 in males ( P<0.05 ). The Ct values of ORF1ab and N were the lowest when sampled at 1-7 days after onset ( P<0.05 ), which were 27.84±4.80 and 28.35±4.65. The Ct values of ORF1ab ( rs=0.288, P=0.001 ) and N ( rs=0.296, P=0.001 ) were positively correlated with sampling time. The Ct values of ORF1ab in pharyngeal swab and sputum were 29.19±4.85 and 28.74±6.40, the Ct values of N in pharyngeal swab and sputum were 29.61±4.60 and 29.22±6.10, both without significant differences between different samples ( P>0.05 ). Conclusions Sampling time has a great influence on the Ct values of ORF1ab and N of SARS-CoV-2.