Diagnostic Errors ; Dyspnea ; diagnosis ; Female ; Humans ; Infant ; Male

Objective To analyze the levels of IL-35, IL-10 and TGF-β in women with or without pregnancy and to investigate the correlation between IL-35 and recurrent spontaneous abortion.MethodsLevels of IL-35, IL-10 and TGF-β in serum were analyzed by enzyme-linked immunosorbent assay (ELISA) in 120 gravidas with normal pregnancy, 40 gravidas with a history of recurrent spontaneous abortion, 40 healthy postpartum women and 40 healthy non-pregnant women of childbearing age.Single factor logistic regression analysis was used for correlation analysis.Results The level of serum IL-35 in normal pregnancies was significantly higher than that in non-pregnant women [333.6 (59.32, 1 391) pg/ml vs 123.9 (8.763, 471.7) pg/ml, P<0.001].The level of TGF-β increased significantly in the first trimester as compared with that in non-pregnant women [473.4 (398.0, 580.5) pg/ml vs 379.7 (311.0, 441.3) pg/ml, P<0.01].No significant difference in the level of serum IL-10 was observed between gravidas and non-gravidas [8.602 (5.854, 12.89) pg/ml vs 9.339 (5.691, 12.07) pg/ml, P>0.05].The level of serum IL-35 in gravidas with recurrent spontaneous abortion was significantly lower than that in healthy gravidas in their first trimester [220.4 (4.951, 702.0) pg/ml vs 386.5 (64.37, 1 355) pg/ml, P<0.05].Serum IL-35 was negatively correlated with the occurrence of recurrent spontaneous abortion (regression coefficient=-0.003, OR=0.997).Conclusion The level of serum IL-35 increases in healthy gravidas, but decreases in gravidas with recurrent spontaneous abortion.IL-35, rather than IL-10 or TGF-β, is recognized as an active player in maternal-fetal immune tolerance.

Abstract: Objective　To analyze the distribution and drug resistance of pathogenic bacteria in blood culture specimens of patients with bloodstream infections before and after COVID-19 (2018-2019 and 2020-2021), and to provide scientific basis and reference for rational treatment and effective control of bloodstream infections in the post-epidemic period. Methods Blood culture specimens were collected from patients in Zhongnan Hospital of Wuhan University in the two years before and after the COVID-19 outbreak (2018-2021). The Automated Blood Culture Systems were used to perform blood culture on blood specimens sent for clinical inspection, and the Vitek MS automatic bacterial identification mass spectrometer was used for strain identification and the Vitek 2 automatic bacterial drug susceptibility analyzer was used for drug susceptibility testing and drug resistance analysis. Results　Blood culture specimens were performed on 28 736 patients with suspected bloodstream infection submitted for inspection from January 2018 to December 2019, and a total of 2 181 strains of pathogenic bacteria were detected after removing duplicate strains, with a positive rate of 7.69%, including 1 046 strains of Gram-negative bacteria, accounting for 47.96%. From January 2020 to December 2021, blood culture specimens from 26 083 patients with suspected bloodstream infection were submitted for inspection, and a total of 2 111 strains of pathogenic bacteria were detected after excluding duplicate strains, with a positive rate of 8.09%, including 1 000 strains of Gram-negative bacteria accounted for 47.37%. The drug resistance of Klebsiella pneumoniae was relatively serious, and the sensitivity rate to ertapenem, polymyxin B and tigecycline was more than 90%. The main non-fermentative bacteria Acinetobacter baumannii was more than 50% sensitive to piperacillin/tazobactam, amikacin and polymyxin B. The sensitivity rates of Pseudomonas aeruginosa to piperacillin/tazobactam, ceftazidime, cefepime, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, piperacillin and meropenem were more than 50%. Conclusions　In the two years before and after COVID-19, there are many types of pathogenic bacteria in bloodstream infection, but the distribution do not differ significantly. The pathogens of bloodstream infection are mainly distributed in ICU, hepatobiliary research institute, and nephrology department. Among them, Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii are the main ones, and different pathogens showed great differences in drug resistance.

Adolescent ; Carcinoma, Squamous Cell ; pathology ; surgery ; Cell Transformation, Neoplastic ; Craniopharyngioma ; pathology ; surgery ; Humans ; Male ; Pituitary Neoplasms ; pathology ; surgery

Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; methods ; Female ; Gelatin ; therapeutic use ; Humans ; Liver Neoplasms ; therapy ; Male ; Middle Aged

Wilson’s disease is an autosomal recessive disorder of copper metabolism. The resultant accumulation of copper primarily damages the liver and brain, resulting in hepatic, neurological and psychiatric symptoms. There have been many recent studies advancing the understanding of Wilson’s disease in Asia. There are indications that the incidence of Wilson’s disease in parts of Asia may be relatively high. Many genetic studies have identifi ed various hot spots in theATP7B gene in a variety of the Asian populations. Screening of these hotspot mutations may thus be useful in confi rming the diagnosis. Despite the advances in treatment, lack of familiarity by the health care profession resulting in late diagnosis, and poor access to treatment particularly among those from the developing economies remain areas of major concern.

AIM: To explorethe therapeutic efficacy of treating cataract phacoemulsification remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.
METHODS:Twenty-seven cases ( 27 eyes ) of glaucoma combined cataract surgery(3mo) in the early failure were treated with that the phacoemulsification auxiliary hook into anterior chamber under the original sclera flap, open from the inside have adhesion of the sclera flap. Postoperative follow-up 12mo, the intraocular pressure and best corrected visual acuity were observed.
RESULTS: The postoperative follow- up was 12mo. There were functional filtering bleb in 14(52%) eyes; and the IOP was below 21mmHg in 17 eyes(63%) without any anti- glaucoma drug, and in 7 eyes ( 26%) with 1 - 2 categories of lower intraocular pressure( IOP) drugs, and 3 eyes(11%), failure and the success rate was 89% after 12mo. Average intraocular pressure after 1wk, 1mo, 3mo, 6mo and 12mo were(7. 1±4. 3) mmHg,(10. 5±5. 1) mmHg,(15. 1±4. 8 ) mmHg, ( 16. 8±5. 2 ) mmHg, ( 17. 3±5.1 ) mmHg, significantly lower than the IOP preoperatively(30. 2±6. 8) mmHg (P<0. 01). Average visual acuity ( all of the following were best corrected vision) after 1wk, 1mo, 3mo, 6mo and 12mo was(0. 32±0. 52),(0. 52±0. 42),(0. 55±0. 39),(0. 53±0. 47),(0. 54±0. 42 ). Postoperative 1wk visual acuity deeper than preoperative( 0. 46 ± 0. 44 ) ( P < 0. 05 ), more than all improved compared with preoperative ( P < 0. 05 ). Postoperative anterior chamber bleeding in 5(19%) eyes, all absorbed itself in 3 to 5 days; ciliochoroidal detachment in 7 ( 26%) eyes, except one case need operate, others were conservative treatment to heal. Postoperative continuous low intraocular pressure concurrent macular edema was 1 eyes(4%), 4mo healed after treatment.
CONCLUSION: It is a safe and effective method thattreating phacoemulsification cataract remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.

Objective To investigate the accuracy of computer-assisted interpretation(CAI)in the diagnosis of pediatric critical arrhythmia,and to establish Logistic regression model to evaluate the main risk factors of CAI error.Methods 1147 cases of arrhythmia patients were divided into heart disease(HD)and nonheart disease group(NHD).Candidate risk factors were chosen,from which the vailables statistically significant were entered for logistic regression analysis.Results CAI error rate of HD group and NHD group were 24.9%and 11.4%,showing a significant difference(P＜0.05).Age,underlying diseases,the number of CAI diagnosis entries were the risk factors.Conclusion CAI error pattern was different among HD group and the NHD group.Higher awareness for CAI error risk factors and CAI technology improvement are critical for a lower CAI error rate.

Seven sinapine analogs (6a-6g) were synthesized using cinnamon acid or benzoic acid and their derivatives as starting materials, which obtained from substituted benzaldehyde and malonate. The structures of target compounds were characterized by IR, 1H NMR and elemental analysis. The effects of compounds 6a-6g on the smooth muscle of intestine isolated from rabbit were studied, and the experimental results showed that compounds 6a, 6d and 6g had diastolic action, while 6f had contractile action.

Establishing emergency medicine training mode of integrated traditional Chinese and Western medicine in traditional Chinese Medicine College is of great significance.Through the construction of clinical skills teaching materials,the construction of training base and standard operating procedures (SOP) management,first aid training and related drama contests,and improving teachers' comprehensive quality,we set up emergency medicine training mode of traditional Chinese medicine and Western medicine,which helps students make comprehensive use of first aid knowledge and practical skills of traditional Chinese medicine and Western medicine for syndrome differentiation.