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.

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.

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

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.

Base on the data of blood pressure, plasma lipid, Glu and UA by physical test, Support Vector Machine (SVM) was applied to identify coronary heart disease (CHD) in patients and non-CHD individuals in south China population for guide of further prevention and treatment of the disease. Firstly, the SVM classifier was built using radial basis kernel function, liner kernel function and polynomial kernel function, respectively. Secondly, the SVM penalty factor C and kernel parameter sigma were optimized by particle swarm optimization (PSO) and then employed to diagnose and predict the CHD. By comparison with those from artificial neural network with the back propagation (BP) model, linear discriminant analysis, logistic regression method and non-optimized SVM, the overall results of our calculation demonstrated that the classification performance of optimized RBF-SVM model could be superior to other classifier algorithm with higher accuracy rate, sensitivity and specificity, which were 94.51%, 92.31% and 96.67%, respectively. So, it is well concluded that SVM could be used as a valid method for assisting diagnosis of CHD.
Algorithms ; China ; Coronary Artery Disease ; diagnosis ; Discriminant Analysis ; Humans ; Models, Theoretical ; Neural Networks (Computer) ; Sensitivity and Specificity ; Software ; Support Vector Machine

Adjuvants, Immunologic ; therapeutic use ; Astragalus Plant ; Child ; Child, Preschool ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infant ; Male ; Nucleic Acids ; therapeutic use ; Phytotherapy ; Pneumonia ; drug therapy ; immunology ; Recurrence ; Respiratory Tract Infections ; drug therapy ; immunology ; Tyrosine ; therapeutic use

Objective To investigate the effects of different modes of mechanical ventilation on lung function during open heart surgery in children with pulmonary hypertension (PH). Methods Twenty-four patients with moderate PH aged 3 mon-12 yr 2mon (group M) and twenty-four patients with severe PH aged 3 mon-7yr 9mon (group S) were further divided randomly into 3 subgroups based on the modes of mechanical ventilation used: pressure-controlled ventilation(PCV) only and alveolar pressure (Palveo) was maintained at 0 cm H2O during CPB (group M1/S1 n = 8); PCV + PEEP (2 cm H2O) and Palveo was maintained at 2 cm H2O during CPB (group M2/S2 n = 8); and PCV+ PEEP (4 cm H2O) and Palveo was maintained at 4 cm H2O during CPB (group M3/S3 n=8). The patients were premedicated with atropine 0.01 mg ?kg -1 and midazolam 0. 1 mg?kg-1 . Anesthesia was induced with fentanyl 20?g?kg-1 and vecuronium 0. 1 mg?kg-1 and maintained with vecuronium infusion(70?g?kg-1?h-1 ) and inhalation of N2O-O2 and isoflurane. The children were mechanically ventilated after intubation and the ventilatory parameters were VT = 10-12 ml ?kg-1, F = 20 bpm and I : E = 1: 2. Lungs were lavaged and 2-3 ml of aspirate were taken for determination of surfactant. Total protein (TP), total phospholipid -(TPL), saturated phosphatidylcholine (Sat PC) and respiratory system compliance(Crs) was measured before skin incision( T0 ), before CPB (T,), at the end of CPB ( T2) and at the end of surgery(T3 ) . Results (1) Crs decreased significantly at T2 and T3 as compared with that at T0 and T1 in group M1/S1 and M2/S2 but in group M3/S3 there was no significant difference in Crs between T0, T1 and T2-3. (2) Sat PC/TPL and Sat PC/TP decreased significantly after CPB (T2, T3 ) in group M,/S, and M2/S2 but in group M3/S3 there was no significant difference in Sat PC/TP and Sat PC/TPL between T0-1 and T2-3. Conclusion PEEP 4 cm H2O can effectively prevent postoperative lung function from worsening in children with pulmonary hypertension undergoing open heart surgery with CPB.