Objective To observe the effect of antipruritic lotion combined Fuyanxiao with biological dress-ing suppository in the treatment of vulvovaginal candidiasis in pregnancy(VVC)the clinical curative effect and the recurrence rate.Methods 236 patients with pregnancy complicated with VVC,would be in community were randomly divided into the two groups:combination treatment group,single drug group,118 cases in each.Combination therapy using antipruritic lotion combined Fuyanxiao biological dressing suppository combined treatment,the control group was treated by Fuyanxiao biological dressing suppository treatment,two groups of clinical efficacy and recurrence rate after the end of treatment were compared.Results The cure rate in the combined treatment group was 90.68%,which was higher than 57.62 % in the control group(χ2 =10.731,P <0.01);The recurrence rate in the combined treatment group was 3.39%,which was lower than 13.56% in the control group(χ2 =10.733,P <0.05).Conclusion The antipruritic lotion combined Fuyanxiao biological dressing suppository in the treatment of pregnancy with VVC can effectively improve the clinical symptoms of patients,reduce the recurrence rate.

Objective To explore the correlation among serum total bilirubin (TBil) , invasive hemodynamic parameters, plasma N-terminal proBNP (NT-preBNP) and C reactive protain (CRP)in patients with heart failure. Methods Invasive hemodynamic parameters derived from Swan-Ganz catheter, TBil, plasma NT-proBNP and CRP within 12 hours after hospital admission were analyzed in 130 patients with chronic heart failure [Now York Heart Association (NYHA) class Ⅱ -Ⅳ]. Results Compared with those in non-hyperbilirubinemia group, pulmonary capillary wedge pressure (PCWP), NT-proBNP and left ventriculure ejection fraction were different significantly in total hyperbilirubinemia group [(26. 09 vs 16.00) mm Hg(1 mm Hg =0. 133 kPa), (3.36 vs2.91) pmol/L, (34. 12 vs 28.92)%, P<0. 05]. The serum TBil increased significantly in higher PCWP, right atrial pressure and NT-proBNP groups than those in lower level groups [(32. 22 vs 24. 17), (37.52 vs 24. 19), (32. 14 vs 16. 74) pmol/L, P < 0.05]. Partial correlation analysis showed serum TBil was associated with PCWP, right atrial pressure, pulmonary vascular resistance index and NT-proBNP respectively (r = 0. 21, P = 0. 02; r = 0. 33, P < 0. 01 ; r = 0. 20, P =0. 04;r = 0. 37, P <0. 01, respectively). Multiple linear regression analysis showed both right atrial pressure and NT-proBNP correlated independently with serum TBil(β= 0. 39, P < 0. 01 ;β = 0. 29,P = 0. 01, respectively). Conclusion For patients with heart failure, serum TBil correlated well with right atrial pressure, PCWP and NT-proBNP; it is a reliable indicator for exact clinical evaluation of heart failure.

Objective To investigate the MRI features of serous borderline ovarian tumor(SBOT).Methods The clinical and MRI features of 1 1 patients with SBOT were retrospectively reviewed and compared with surgical and pathologic findings.Results There were 5 bilateral and 6 unilateral cases,and the maximum diameter was 4.4-20.7 cm.According to the MRI appearances,it was divided into surface papillary and cystic papillary subtypes by morphological features and exophytic and endophytic proj ections by growth of papillary architecture.The papillary architecture with internal branching was the characteristic MRI appearance,the papillary architecture showed hypo-intensity on T1WI and hyper-intensity on T2WI with a lobulated contour,the internal branching showed hypo-intensity on T1WI and T2WI.The papillary architecture was obviously enhanced,while the internal branching was slightly enhanced after inj ection of contrast agent.Conclusion The papillary architecture with internal branching is a characteristic MRI appearance of SBOT which provides information for the diagnosis and differential diagnosis;and the types according to the MRI appearances and growth pattern of papillary architecture provides reference for the treatment and prognosis.

Objective To investigate the prevalence and related factors of hyperuricemia in military pilots,and to provide an objective basis for the prevention and treatment of hyperuricemia.Methods A total of 389 pilots who underwent annual physical examination in our department from 2020 to 2021 were selected as the research objects.The detection of hyperuricemia was analyzed,and the serum uric acid values of pilots with different body mass index,type of aircraft and flight time were compared.Logistic multiple regression analysis was performed with serum uric acid(UA)as the dependent variable,fasting blood glucose systolic blood pressure,diastolic blood pressure,body mass index(BMI),serum creatinine,total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),triglyceride and glucose index(TyG index),cystine protease inhibitor C(Cys-C)and other indicators as independent variables to clarify the relationship between UA value and these indicators.Results Among the 389 pilots,there were 46 cases of hyperuricemia,and the total detection rate was 11.83%.According to the occupational related factors BMI,aircraft type and flight time,the average UA values of pilots with different BMI groups were statistically significant(F=5.333,P=0.005),while the average UA values of pilots with different aircraft types and flight time groups were not statistically significant(F=1.502,P=0.224;F=0.375,P=0.866).Logistic multiple regression analysis showed that creatinine(OR=1.09,P<0.01),triglyceride(OR=5.10,P<0.01),high density lipoprotein(OR=0.14,P<0.01),low density lipoprotein(OR=1.99,P<0.05)and TyG index(OR=2.15,P<0.05)were independent risk factors for hyperuricemia.Conclusion Creatinine,blood lipid level and TyG index are closely related to hyperuricemia.

A case of acute kidney injury in a military pilot after taking normal dose of diclofenac sodium capsules for 2 days was reported.Serum creatinine 519.1 μmol/L,blood urea 15.01 mmol/L,blood uric acid 590.4 μmol/L were tested,and dexamethasone injection was given intravenously.After 8 days,renal function returned to normal.After 1 month of ground observation,the patient was generally in good condition,and the abdominal ultrasound,renal vascular ultrasound,hematuria routine,and renal function were all normal.After discussion and decision by the Special Service Health Identification Committee,the aviation medical identification conclusion was that the flight was qualified.This article shows that military pilots should carefully read the drug instructions before taking diclofenac sodium capsules due to their illness,pay close attention to renal function after medication,and effectively ensure the safety of medication while maintaining the stability of the combat effectiveness of the troops.

Objective:To analyze the clinical characteristics of Group A Streptococcal(GAS) toxic shock syndrome (STSS) in children. Methods:The clinical data of 10 STSS children hospitalized in Shenzhen Children′s Hospital from January 2015 to March 2022 were downloaded from the electronic medical record system.The clinical manifestations were analyzed and treatment experience was summarized respectively.Results:There were 5 males and 5 females, with an average age of (5.29±2.87) years.All the patients were healthy in the past.The diagnoses were confirmed by blood culture in 2 cases, pus culture in 5 cases, and blood metagenomics next generation sequencing in 3 cases.The rapid detection of GAS antigen was positive in 7 cases.All cases had fever, and 9 cases of them developed fever after viral infection, including pneumonia in 7 cases, skin and soft tissue infections in 6 cases, necrotizing fasciitis in 3 cases, and purulent meningitis in 1 case.All cases also presented with shock.Six cases had liver function injury, and 4 cases suffered from acute kindey injury.Four cases had infection-related encephalopathy, and 7 cases were afflicted with disseminated intravascular coagulation.Two cases had respiratory failure, and 2 cases had rhabdomyolysis.There were 3 cases with a decreased white blood cell (WBC) count and 7 cases with an increased WBC count on admission.Seven cases were found to have thrombocytopenia, but their platelet levels were all elevated after recovery.C-reactive protein and procalcitonin and the proportion of neutrophils were markedly increased in all cases.All cases suffered from hypoalbuminemia, hyponatremia and hypocalcemia.All the 10 positive strains were sensitive to Penicillin, Ceftriaxone/Cefotaxime and Vancomycin.Eight cases were treated with combined antibiotics after admission.Eight patients received intravenous immunoglobulin.All cases were cured and discharged.Conclusions:The STSS progresses rapidly in children, so pediatricians should pay great attention to the disease.Early identification, diagnosis of infection sources, infusion of antibiotics and surgical treatment are the keys to disease management.

Objective:To explore the distribution characteristics and antibiotic resistance of pathogen in children with hematological disorders and cancers complicated with sepsis in pediatric intensive care unit (PICU).Methods:The clinical data of children with hematological disorders and cancers complicated with sepsis hospitalized at Shenzhen Children′s Hospital affiliated to China Medical University from January 2016 to August 2023 were retrospectively analyzed. Patients were divided into survival group and death group based on the outcome of sepsis on 28 days after diagnosis.Results:A total of 202 sepsis episodes occurred in 176 children were enrolled in this study. Among all, 144 (71.3%) cases of bloodstream infection, 59 (29.2%) cases of pulmonary infection, 21 (10.4%) cases of abdominal infection, 9 (4.5%) cases of soft tissue infection, 9 (4.5%) cases of nervous system infection, and 3 (1.5%) cases of urinary tract infection. A total of 244 pathogenic strains were identified, in which 74 (30.3%) cases were gram-positive bacteria. The top 3 pathogens isolated were Coagulase negative Staphylococcus (21 strains), Staphylococcus aureus (19 strains) and Streptococcus pneumoniae (13 strains). Gram-negative bacteria accounted for 122 (50.0%) strains, in which top 3 were Klebsiella pneumonia (33 strains), Escherichia coli (25 strains), and Pseudomonas aeruginosa (23 strains). Fungi comprised 48 (19.7%) strains:the top 3 were Candida tropicalis (14 strains), Candida albicans (10 strains), Aspergillus and Pneumocystis jirovecii (7 strains each). The incidence of Acinetobacter baumannii, Stenotrophomonas maltophilia, and Pseudomonas aeruginosa were significantly higher in death group compared to survival group[9.0%（6/67）vs. 2.3%（4/177）, χ2＝3.971 ，P＝0.046; 9.0%（6/67）vs. 1.1%（2/177）, χ2＝7.080 ，P＝0.008;16.4%（11/67）vs. 6.8%（12/177）, χ2＝5.288 ，P＝0.021]. The samples of 57 cases were simultaneously detected by both culture and metagenomic next-generation sequencing (mNGS). Pathogens were detected in 25 cases by both culture and mNGS. In 30 cases, pathogen detection were mNGS positive but culture negative. Two cases showed positive results only with culture. A total of 79 (46.8%) strains were multi-drug resistant bacteria, including 27 (34.2%) strains of gram-positive bacteria and 52 (65.8%) strains of gram-negative bacteria. A total of 174 (86.1%) children with sepsis received empirical anti-infective drugs within 24 hours of fever onset. A total of 124 (61.4%) cases were appropriately covered by the initial empirical antibiotics, while 40 (19.8%) cases were not adequately covered and 10 (5.0%) cases had incomplete coverage. Despite the inclusion of pathogenic in the coverage, resistance to initial antibiotics was observed in 22 (10.9%) cases. Fifty-one patients died. Conclusion:The predominant pathogens responsible for sepsis in PICU with hematological disorders and cancers is gram-negative bacteria, followed by gram-positive bacteria and fungi. In comparison to healthy children with sepsis, there is a higher incidence of fungal infections among hematological disorders and cancers. The proportion of multi-drug resistant bacteria infection is high. Early identification and combination of local etiological distribution and drug resistance, along with the empirical selection of appropriate anti-infection treatment strategies, can greatly enhance survival rate.