Objective To observe the safety and effect of magnetotherapy on rabbits with cerebral hemorrhage. Methods Fifty rabbits was used to establish the model of cerebral hemorrhage by perforating the mid artery of brain. CT and dissection were used to observe the hemorrhage. Forty five rabbits were divided into control group, 0.4T magnetic group and 0.8T magnetic group. Observation of the hemorrhage before magnetotherapy and the hemorrhagic absorption after magnetotherapy was conducted with CT scan. Results All of the 50 rabbits manifested such symptoms as weakness, low tension, and low or absent reflex on the contralateral hind limb of the operation side. Cerebral hemorrhage was proved by CT scan and dissection. There was no difference in hemorrhage between magnetotherapy and control group before magnetotherapy. After magnetotherapy, there was significant difference between the magnetotherapy and the control groups, with regard to the hemorrhagic absorption, but no difference between the 0.4T and 0.8T groups was observed. Conclusion Magnetotherapy could improve the intracranial hemorrhagic absorption in rabbit without resulting in secondary hemorrhage.

OBJECTIVETo evaluate the short-term outcomes and complication management of submucosal tunneling endoscopic resection(STER) for esophageal submucosal tumors (SMTs) originating from the muscularis propria(MP) layer.

METHODSClinical data of 48 patients with esophageal SMTs from MP layer undergoing STER in the Department of Gastroenterology, the First People's Hospital of Xiangshan, Zhejiang, and the Endoscopy Center of Zhongshan Hospital, Fudan University, Shanghai between September 2013 and August 2014 were retrospectively analyzed. The clinicopathological features, complication management, and short-term outcomes were evaluated.

RESULTSAll the patients underwent STER successfully. The complete resection rate was 100%. The mean maximum diameter of the lesions was (22.9±12.1) mm (range 9.0-60.0 mm), and the mean operation time 41.8 min (range 15.0-140.0 min). Intraoperative mucosal injury occurred in 5 patients (10.4%), which was successfully clipped, pneumoperitoneum in 2 patients (4.2%) and subcutaneous emphysema in 3 patients(6.3%), which were successfully controlled with conservative treatments. Five patients (10.4%) had postoperative severe chest pain. Seven patients (14.6%) developed fever, among them, 5 were managed by conservative therapy, and 2 were submucosal tunnel infection, who were successfully treated after reclosing the ruptured tunnel entry with clips. All the removed tumors had tumor-free resection margins. The average length of postoperative hospital stay was 2.4 days (range 1-13 days). Local recurrence and distant metastasis did not occur during mean 6.8 months (range 2-12 months) follow up.

CONCLUSIONSSTER appears to be a safe and effective option for esophageal SMTs originating from MP layer. Common complications related to STER often can be successfully controlled with conservative treatments.

China ; Esophageal Neoplasms ; Esophagoscopy ; Humans ; Mucous Membrane ; Muscle, Smooth ; Operative Time ; Retrospective Studies

Objective To study the occurrence of bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants and to determine the risk factors of severe BPD.Method From January 2007 to January 2017,ELBW infants admitted to neonatal intensive care unit (NICU) in Hunan Children's Hospital were retrospectively analyzed.They were assigned into severe and mild/moderate groups based on the severity of BPD.The general condition,maternal status,prenatal and delivery room treatment,transportation,clinical courses,therapy and outcome in NICU of the two groups were compared,and the risk factors of severe BPD were analyzed.Result A total of 367 cases were hospitalized during the 10 years.281 ELBW infants with complete medical records survived longer than 28 days were enrolled in this study.Among them,233 had BPD.Among BPD infants,116 cases were in the severe BPD group,47 cases (40.5％) died.117 cases were in the mild/moderate BPD group and 1 case (0.9％) died.The difference between the two groups was statistically significant (P ＜ 0.05).Multivariate Logistic regression analysis showed that the risk factors of severe BPD were duration of mechanical ventilation ≥ 7 days (OR =7.518,95 ％ CI 3.197 ～ 17.676),ventilator-associated pneumonia (OR =3.047,95 ％ CI 1.436 ～ 6.464),1 min Apgar score ≤7 (OR =2.341,95 ％ CI 1.142 ～ 4.796) and patent ductus arteriosus (OR =2.223,95 ％ CI 1.079 ～4.582).Conclusion The incidence and mortality of BPD,especially severe BPD,are high in ELBW infants.Avoiding asphyxia,shortening the time of mechanical ventilation,preventing infection and closing ductus arteriosus are important measures to reduce the severity of BPD.

Objective:To study the clinical features and treatment strategy of neonatal ureaplasma meningitis.Methods:During 2021, the clinical data of 2 neonates with ureaplasma meningitis treated in Children's Hospital of Hunan Province were retrospectively analyzed. Literature on this subject were searched in the following databases: CNKI, Wanfang Database, Chinese Medical Journal Full-Text Database, CQVIP database, SinoMed, PubMed, Embase and Web of Science (up to March 2022). The key words included “infant”, “neonate”, “newborn”, “ureaplasma”, “mycoplasma urealytium”, “meningitis”, “central nervous system infection”, “brain”. The clinical data, treatment and prognosis of patients from the literature were summarized.Results:Case 1, female, gestational age(GA) 33 +3 weeks, intracranial hemorrhage (ICH) and ventricular dilatation were found on 2 d after birth. The cerebrospinal fluid (CSF) routine and biochemistry tests indicated meningitis, but the CSF culture was negative. No improvement after antibiotic treatment. CSF metagenomic next-generation sequencing (mNGS) and 23S rRNA showed Ureaplasma urealyticum on 30 d after birth. The patient was treated with doxycycline (DOX) for 21 d until mNGS turned negative and DOX was discontinued. However, the disease recurred 23 d later and erythromycin was added with DOX as combined therapy. The patient was followed up until 6 months without neurodevelopmental disabilities. Case 2, male, GA 26 weeks, ICH and ventricular dilatation were found on 10 d after birth. The CSF routine and biochemistry tests indicated meningitis, but the CSF culture was negative. No improvement after antibiotic treatment. CSF mNGS and 23S rRNA showed Ureaplasma parvum. The patient received erythromycin therapy for 32 d and had normal neurodevelopment at 5 months. According to the literature, 43 cases were reported including the 2 cases descirbed above, 17 cases were full-term infants and 26 cases were preterm infants. The median CSF leukocytes, glucose and proteins were 566 cells/mm 3, 0.2 mmol/L and 2.2 g/L. 27 cases were diagnosed based on CSF culture, 6 cases using mNGS, 4 cases with both CSF culture and PCR method and 6 cases with other methods. Macrolides alone were used in 14 cases, macrolides combined with another antibiotic were used in 8 cases, non-macrolide antibiotics were used in 9 cases and 12 cases didn't receive any anti-ureaplasma therapy. All 17 term infants survived, however, 8 cases with hydrocephalus. Among the 26 preterm infants, 8 patients died, 18 patients had periventricular-intraventricular hemorrhage and 15 patients had hydrocephalus. Conclusions:Neonatal ureaplasma meningitis has significantly lower CSF glucose level with hydrocephalus as the common complication. For intracranial infections of unknown etiology and no response to treatment, mNGS is helpful in determining the pathogen.Neonatal ureaplasma meningitis should be treated with macrolides alone or as add-on therapy.