OBJECTIVE To analyze 28 cases in an outbreak of neonatal enterovirus nosocomial infection during summer of 2006.METHODS Demographic characteristics,clinical manifestations,laboratory data and outcome were analyzed to reveal the clinical severity.RESULTS The outbreak lasted more than one month and the nosocomial infection rate increased to 6.4%.There were 22 cases(78.6%) first presented with fever.Half of the patients were detected enterovirus from blood or cerebrospinal fluid by PCR.All of the 28 cases were diagnosed enterovirus infection based on the contact history,clinical signs and laboratory results.Among them,ten cases had viral meningitis.All patients discharged home after hospitalization with no sequelae.CONCLUSIONS Although this group of neonatal enterovirus infection developed viral meningitis,they had relatively mild illness with benign clinical course.Extreme vigilance is required in interrupting the spread of nosocomial enterovirus infections in neonatal units.This includes respect of strict hygiene measures and meticulous hand-washing.

ObjectiveTo investigate prognostic factors in Stage Ⅲ non-small cell lung cancer (NSCLC)treated with definitive radiation therapy (RT) with PET-CT-based radiotherapy planning. MethodsFifty nine patients with Stage Ⅲ NSCLC treated with radiation therapy of 60 Gy or more were enrolled into this study.The impact of prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The following-up rate was 98％.Nineteen patients completed 2 years' followed-up. The overall l-year and 2-year survival rate was 66％ and 37％, respectively, with a median survival time of 17 months. At a univariate analysis, cigarette smoking status, T stage, radiation dose, the standardized uptake value, the gross tumor volume and clinical stage were significant prognostic factors ( x2 =7.46,7. 52,8.37,4. 97,5.82,4. 37, P =0. 006,0. 006,0. 004,0. 026,0. 016,0. 037, respectively ).At multivariate analyses, cigarette smoking status, radiation dose, gross tumor volume and clinical stage were significant prognostic factors ( x2 =6. 20, 9. 69, 6. 39, 10. 09, P =0. 013,0. 002, 0. 011,0. 001,respectively). Conclusions Cigarette smoking status, radiation dose, gross tumor volume and clinical stage are significant prognostic factors on survival in patients with Stage Ⅲ NSCLC treated with RT based on PET-CT radiotherapy planning.

Objective:To investigate the hemodynamic changes of the main arteries and veins of the extremities and the heart in patients with hypertrophic scar secondary to extensive burns after pressure treatment, and to analyze the relevant mechanisms.Methods:A retrospective before-after self-control study was conducted. From January 2017 to February 2022, 37 patients with hypertrophic scar secondary to extensive burns who met the inclusion criteria were hospitalized in the Burn Rehabilitation Department of Guangdong Industrial Injury Rehabilitation Hospital, including 25 males and 12 females, aged 23-52 years. The patients were admitted to the hospital within 12 weeks after wound healing, and within one week after admission, rehabilitation therapists, occupational therapists, and tailors custom-made pressure products such as full-body pressure garment, pressure pants, vests, split finger gloves, split finger socks, hoods, and plastic collars, with the pressure at each part maintained at 2.67-4.00 kPa when wearing. Before the first treatment with pressure products (hereinafter referred to as before pressure treatment) and at 1 h of the first treatment with pressure products (hereinafter referred to as 1 h of pressure treatment), color Doppler ultrasonography was performed to check the pulse rate of the axillary artery, the lumen diameter, peak systolic velocity (PSV), and resistance index of the axillary artery and femoral artery on the left side, the lumen diameter, cross-sectional area, and average blood flow velocity of the axillary vein and femoral vein, and the mitral valve E peak, mitral valve A peak, tricuspid valve E peak, aortic valve PSV, and pulmonary valve PSV of the heart; an optical chromatographic skin detector was used to detect the red color, red pigment, and surface brightness of the scar on the back of the hand to reflect the filling and distribution of the scar microvessels. Data were statistically analyzed with paired sample t test. Results:Compared with those before pressure treatment, the PSV of the axillary artery of patients was significantly slowed down at 1 h of pressure treatment ( t=55.42, P<0.01); the average blood flow velocity of the axillary vein was significantly accelerated ( t=-60.50, P<0.01); the pulse rate, lumen diameter, and resistance index of the axillary artery, as well as the lumen diameter and cross-sectional area of the axillary vein did not change obviously ( P>0.05); the average blood flow velocity of the femoral vein was significantly accelerated ( t=-80.52, P<0.01); the lumen diameter, PSV, and resistance index of the femoral artery, as well as the lumen diameter and cross-sectional area of the femoral vein had no significant change ( P>0.05); the mitral valve E peak and mitral valve A peak of the heart decreased significantly (with t values of 10.71 and 21.96, respectively, P<0.01); the tricuspid valve E peak of the heart increased significantly ( t=7.57, P<0.01); the PSV of the aortic valve and pulmonary valve of the heart did not change obviously ( P>0.05). At 1 h of pressure treatment, the red color and red pigment values of the scar on the back of the hand of patients were 15.3±1.1 and 16.8±1.2, respectively, which were significantly lower than 24.5±1.3 and 23.8±1.2 before pressure treatment (with t values of 8.32 and 8.04, respectively, P<0.01). The brightness value of the scar surface on the back of the hand of patients at 1 h of pressure treatment was similar to that before pressure treatment ( P>0.05). Conclusions:After pressure treatment for the hypertrophic scar in patients secondary to extensive burn, the average blood flow velocity of the axillary vein and femoral vein in patients are obviously accelerated, the PSV of the axillary artery is significantly slowed down, the peak values of mitral valve E and mitral valve A of the heart are significantly decreased, and the tricuspid valve E peak is significantly increased. These hemodynamic changes may be related to the reduction of microvascular blood flow in the local area of scar after systemic pressure treatment.

Objective To evaluate the quality of coenzyme Q₁₀ emulsion with improved formulation and technology and establish an assay method. Methods Coenzyme Q₁₀ emulsion with a high oil concentration was prepared and analyzed by HPLC. The physical and chemical properties of the emulsion were characterized, and the entrapment efficiency was determined. The stability of sterilization, freeze-thaw and dilution was investigated. The photodegradation test as well as the influencing factors, acceleration and long-term stability tests were carried out. Results The particle size, Zeta potential, pH value, content and entrapment efficiency of coenzyme Q₁₀ emulsion were (239.5±0.8) nm、(−32.28±2.04) mV、(5.86±0.02)、 (100.59±1.24) % and (98.5±1.1) %, respectively. The stability of sterilization, freeze-thaw and dilution was good. The photolysis rate was directly proportional to the dilution ratio and inversely proportional to the drug loading. Coenzyme Q₁₀ emulsion should be prepared in light free environment and stored at a low temperature. The pH value dropped 0.61 when it was kept in darkness at (40±2) ℃ for 10 days. It exhibited good stability both in the accelerated and long-term test. Conclusion The physicochemical properties of coenzyme Q₁₀ emulsion with a high oil concentration meet the quality requirements for intravenous injection with good stability.

Immunoscenescence plays a key role in the initiation and development of tumors. Furthermore, immunoscenescence also impacts drug delivery and cancer therapeutic efficacy. To reduce the impact of immunosenescence on anti-tumor therapy, this experimental plan aimed to use neutrophils with tumor tropism properties to deliver sialic acid (SA)-modified liposomes into the tumor, kill tumor cells via SA-mediated photochemotherapy, enhance infiltration of neutrophils into the tumor, induce immunogenic death of tumor cells with chemotherapy, enhance infiltration of CD8⁺ T cells into the tumor-draining lymph nodes and tumors of immunosenescent mice, and achieve SA-mediated photochemotherapy. We found that CD8⁺ T cell and neutrophil levels in 16-month-old mice were significantly lower than those in 2- and 8-month-old mice; 16-month-old mice exhibited immunosenescence. The anti-tumor efficacy of SA-mediated non-photochemotherapy declined in 16-month-old mice, and tumors recurred after scabbing. SA-mediated photochemotherapy enhanced tumor infiltration by CD8⁺ T cells and neutrophils, induced crusting and regression of tumors in 8-month-old mice, inhibited metastasis and recurrence of tumors and eliminated the immunosenescence-induced decline in antitumor therapeutic efficacy in 16-month-old mice via the light-heat-chemical-immunity conversion.

Objective: To investigate the effect of cough assist on sputum excretion and the outcome of withdrawal of mechanical ventilation after mechanically ventilated chronic obstructive pulmonary disease (COPD) patients with cough weakness. Methods: From January 2017 to December 2018, 74 patients with cough and weakness COPD after extubation of mechanical ventilation in the Department of Respiratory Critical Care Medicine of Hunan Provincial People's Hospital were divided into control group(n=37) and observation group (n=37) according to the random number table method. The patients in the control group were treated routinely after weaning and extubation, and the observation group was treated with cough assist after withdrawal of mechanical ventilation and extubation on the basis of the control group. The differences in drainage effect, blood gas index, reintubation rate and early prognosis index between the two groups were compared. Results: After the intervention treatment, the first active sputum excretion and the total sputum volume on the first day were (5.6±3.4) ml and (33.1±5.2) ml in the observationgroup, and (4.2 ±2.0) ml and (29.1±7.4) ml in the control group, the difference was statistically significant (t=-2.10, 2.875, P<0.05). The number of significant cases of respiratory sound improvement in the observation group and the control group was 21 and 14 cases, respectively, and the difference between the two groups was statistically significant (Z=-1.974, P < 0.05). The oxygen partial pressure (PaO₂) and oxygenation index (PaO₂/FiO₂) carbon dioxide partial pressure (PaCO₂) values of the observation group were (80.0±8.4), (345.9±19.2), (46.7±6.6)mmHg, and (74.8±9.1), (310.7±21.9), (50.9±7.1)mmHg in the control group. The difference was statistically significant (t=-2.504,-2.710, 2.579, all P<0.05). The reintubation rate, noninvasive ventilation time, and hospitalization days after the initial extubation in the observation group were as follows: 5.6%(2/36), (64.1±18.9)h, (6.0±1.7)d, and 22.2%(8/36), (76.7±15.3)h, (7.2±2.8)d in the control group. The difference was statistically significant (χ²=4.181, t=2.528, 2.438, all P<0.05). The non-invasive ventilation rate within 72h in the observation group and the control group were 63.9% (23/36) and 75.0% (27/36), the difference was not statistically significant (χ²=0.222, P>0.05). Conclusions The application of cough assist in RICU patients with cough weakness after extubation by mechanical ventilation can improve the expectoration efficiency of cough, improve oxygenation, reduce carbon dioxide retention, reduce the rate of re-intubation, shorten the time of noninvasive ventilation and hospitalization after extubation, and improve the curative effect.

OBJECTIVETo investigate the relationship of the mutational status of the ND4 gene and the clinical features of acute myelogenous leukemia (AML) patients with ND4 mutations.

METHODSUsing PCR combined with directly sequencing, we identified somatic mutations of ND4 in 121 primary AML patients to couple with their clinical features.

RESULTSThere were 58 male patients and 63 female patients (median age 49 years, 10-86 years). Eight of 121 patients (6.6%) with de novo AML were found harboring missense mutation of ND4 gene, including 3 patients with A131V (3/8, 37.5%), 2 patients with A404T (2/8, 25%), 1 patient with F149L (1/8, 12.5%), 1 patient with G242D (1/8, 12.5%) and 1 patient with Y409H (1/8, 12.5%), respectively. Patients with ND4 mutations were associated with good karyotype (P=0.049), regardless of gender, age, white blood cell, hemoglobin, platelet, blast cells of bone marrow or immunophenotype (P>0.05). There were no statistical significance in mutations of FLT3-ITD, NPM1, CEBPA, c-KIT and DNMT3A between patients with ND4 mutation and wild-type (wt) ND4 (P>0.05). The median overall survival of patients with ND4 mutations and wt ND4 were all not reached. The median relapse-free survival were not reached and 29(2-53) months, respectively (P>0.05). There was no significance in the ratio of CR and RR patients between wt ND4 and ND4 mutated groups (P>0.05).

CONCLUSIONIt was concluded that novel ND4 mutations could be found in de novo AML patients, especially in patients with good karyotype. Thus, ND4 mutations might play an important role in AML prognosis. However, whether the mitochondria dysfunction contribute to leukemogenesis needs to be further investigated.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; Male ; Middle Aged ; Mutation ; NADH Dehydrogenase ; genetics ; Prognosis ; Young Adult