To explore the clinical characteristics of primary intracranial germ cell tumors (iGCT) and analyze the risk factors for the occurrence of neuroendocrine dysfunction.Methods:A case series study was conducted. The data of 130 children diagnosed with iGCT who were admitted to the Department of Pediatrics, Beijing Tiantan Hospital, Capital Medical University, from February 2021 to December 2023 was collected. The clinical characteristics of iGCT were summarized, including general information, clinical manifestations, imaging findings, laboratory tests and outcomes. Children were divided into groups aged 0-9 and 10-18 years, and divided into group non-neuroendocrine dysfunction, group partial neuroendocrine dysfunction and group combined hypothalamic and pituitary-target gland axis dysfunction. Multivariate Logistic regression was employed for statistical analysis to identify risk factors for neuroendocrine dysfunction in iGCT children.Results:A total of 130 iGCT children were included, with an age of (10±3) years, 87 males and 43 females. Among them, 82 children (63.1%) had germinoma and 48 children (36.9%) had non-germinomatous germ cell tumors (NGGCT). One hundred and ten children (84.6%) had single lesions, including 47 cases in the sellar region, 29 cases in the pineal region and 34 cases in the basal ganglia region. Multi-leisions presented in the 20 children (15.4%), with 10 cases in the sellar+pineal region, 6 cases in the sellar+basal ganglia region, 3 cases in the pineal+ganglia region and 1 case in the sellar+pineal+basal ganglia region. Dissemination was presented to 26 children (20.0%). Initial clinical manifestations presented with symptoms of cranial hypertension like headache and vomiting in 75 cases, vision changes in 28 cases, limb movement disorders in 42 cases, diabetes insipidus in 67 cases, precocious puberty in 23 cases, growth retardation in 22 cases and delayed puberty in 2 cases. Among the 72 children aged 0-9 years, 37 cases (51.4%) had germinoma and 35 cases (48.6%) had NGGCT, while among the 58 children aged 10-18 years, 45 cases (77.6%) had germinoma and 13 cases (22.4%) had NGGCT. Non neuroendocrine dysfunction group included 39 children, partial neuroendocrine dysfunction group 54 children, and combined hypothalamic and pituitary-target gland axis dysfunction group 37 children. Univariate analysis showed statistical difference in gender, disease duration, tumor location, and serum human chorionic gonadotropin level among the 3 groups (all P<0.05). Multivariate Logistic regression analysis revealed that girl ( OR=5.29, 95% CI 1.54-18.16) and long disease duration ( OR=1.07, 95% CI 1.01-1.14) were risk factors for neuroendocrine dysfunction in iGCT patients (both P<0.05). Conclusions:iGCT occurs in children of all ages, with a higher incidence in males. The proportions of germinoma and NGGCT are similar in children aged 0-9 years, while germinoma is more common in patients aged 10-18 years. The clinical symptoms are atypical and diverse. Female gender and longer disease duration demonstrate the presence of neuroendocrine dysfunction in iGCT.

To explore the clinical characteristics of primary intracranial germ cell tumors (iGCT) and analyze the risk factors for the occurrence of neuroendocrine dysfunction.Methods:A case series study was conducted. The data of 130 children diagnosed with iGCT who were admitted to the Department of Pediatrics, Beijing Tiantan Hospital, Capital Medical University, from February 2021 to December 2023 was collected. The clinical characteristics of iGCT were summarized, including general information, clinical manifestations, imaging findings, laboratory tests and outcomes. Children were divided into groups aged 0-9 and 10-18 years, and divided into group non-neuroendocrine dysfunction, group partial neuroendocrine dysfunction and group combined hypothalamic and pituitary-target gland axis dysfunction. Multivariate Logistic regression was employed for statistical analysis to identify risk factors for neuroendocrine dysfunction in iGCT children.Results:A total of 130 iGCT children were included, with an age of (10±3) years, 87 males and 43 females. Among them, 82 children (63.1%) had germinoma and 48 children (36.9%) had non-germinomatous germ cell tumors (NGGCT). One hundred and ten children (84.6%) had single lesions, including 47 cases in the sellar region, 29 cases in the pineal region and 34 cases in the basal ganglia region. Multi-leisions presented in the 20 children (15.4%), with 10 cases in the sellar+pineal region, 6 cases in the sellar+basal ganglia region, 3 cases in the pineal+ganglia region and 1 case in the sellar+pineal+basal ganglia region. Dissemination was presented to 26 children (20.0%). Initial clinical manifestations presented with symptoms of cranial hypertension like headache and vomiting in 75 cases, vision changes in 28 cases, limb movement disorders in 42 cases, diabetes insipidus in 67 cases, precocious puberty in 23 cases, growth retardation in 22 cases and delayed puberty in 2 cases. Among the 72 children aged 0-9 years, 37 cases (51.4%) had germinoma and 35 cases (48.6%) had NGGCT, while among the 58 children aged 10-18 years, 45 cases (77.6%) had germinoma and 13 cases (22.4%) had NGGCT. Non neuroendocrine dysfunction group included 39 children, partial neuroendocrine dysfunction group 54 children, and combined hypothalamic and pituitary-target gland axis dysfunction group 37 children. Univariate analysis showed statistical difference in gender, disease duration, tumor location, and serum human chorionic gonadotropin level among the 3 groups (all P<0.05). Multivariate Logistic regression analysis revealed that girl ( OR=5.29, 95% CI 1.54-18.16) and long disease duration ( OR=1.07, 95% CI 1.01-1.14) were risk factors for neuroendocrine dysfunction in iGCT patients (both P<0.05). Conclusions:iGCT occurs in children of all ages, with a higher incidence in males. The proportions of germinoma and NGGCT are similar in children aged 0-9 years, while germinoma is more common in patients aged 10-18 years. The clinical symptoms are atypical and diverse. Female gender and longer disease duration demonstrate the presence of neuroendocrine dysfunction in iGCT.

Objective:To investigate the interfering factors in the determination of creatinine(Cr) using the American Clinical Laboratory Standards Association (CLSI) EP7-A3 document.Methods:According to the CLSI EP7-A3 document, fresh serum (no hemolysis, lipemia, and jaundice) was used on the day of the experiment and confirmed the interfering substances through the pairing difference experiment and the point-to-point analysis method was used in the dose effect experiment to clarify the difference of interfering substances.Results:Triglyceride (16.94 mmol/L), dobutamine hydrochloride (4.01 μmol/L), ascorbic acid (298 μmol/L) did not interfere with the determination of Cr. Free bilirubin (684 μmol/L), conjugated bilirubin (684 μmol/L), calcium hydroxybenzene sulfonate (144 μmol/L) and hemoglobin (10 g/L) were used as the maximum concentrations of interferences for the dose effect test, the results showed that the above interferences had negative interference on the determination of Cr.Conclusion:According to EP7-A3, it is valuable to evaluate the interference factors of creatinine determination.

In physiological conditions, a diverse microbiota might enhance host defense. However, the gut microbiota of critically ill patients is characterized by lower diversity, lower abundances of key commensal genera, and overgrowth by one bacterial generation, a state known as dysbiosis. Increasing evidences indicate that microbiota-derived components can reach the systemic circulation from the gut and modulate immune homeostasis. Dysbiosis could have greater consequences for the critically ill patients and might contribute to poor outcome. In this review, we highlighted the crucial role of intestinal microbiota in systemic homeostasis in the critically ill patients and summarized emerging evidence in the field of microbiota-targeted therapies. This would provide new perspective for further establishing the causes and consequences of dysbiosis found in the critically ill patients as well as developing new strategies of intervention.

BACKGROUND: It is recently found that some kinds of antibiotics can aggravate the obstruction of neuromuscular junction(NM J) transmission,exacerbate myasthenia gravis (MG). Hitherto, there are few reports about the effect of antibiotics on transitive function on animal models. Along with the appearance of new antibiotics, the effects of the antibiotics on NMJ transitive function need to be further observed.OBJECTIVE: To investigate the effect of aminoglycoside antibiotics, fluoroquinolone antibiotics and cephalosporin antibiotics on the transitive function of NMJ in MG, and to provide an experimental basis for using those antibiotics securely in clinic and for selecting those antibiotics to treat MG properly.DESIGN: Randomized controlled study based on experimental animals.SETTING: Department of nosocomial infection, neurology and pharmacy in a university hospital.MATERIALS: The experiment was conducted at the Neurological Institute of Tongji Medical College, Huazhong University of Science and Technology from March 2002 to January 2003. Totally 150 healthy female C57BL/6mice, 6 - 8 weeks old, weighting 18 - 20 g, were divided randomly into 4groups: normal group( n = 10), MG group( n = 10), saline group( n = 10)and antibiotics group( n = 120) . Mice in antibiotics group were divided randomly again into gentamicin group, etimicin group, ciprofloxacin group,fleroxacin group, cefuroxime group and cephradine group, with 20 mice in each group.INTERVENTIONS: C57BL/6 mice were immunized with the acetylcholine receptor(AChR) protein in complete Fruend' s adjuvant(CFA) to establish experimental autoimmune myasthenia gravis(EAMG) . Mice in saline group were injected normal saline and mice in antibiotics group were injected antibiotics(10 mg/kg), lasted 14 days. Mice in MG group were without any treatments. On the 7th day after the last immunization and the 14th day after the antibiotics treatments, MG scores was evaluated, repetitive nerve stimulation(RNS) and the levels of acetylcholine receptor antibody(AChRab)were tested at the same time.RESULTS; The mean symptom scores on the 14th day after the antibiotics treatment with gentamicin, etimicin, ciprofloxacin and fleroxacin were higher than that in MG group, and there was no significant difference in the mean symptom scores among cefuroxime group, cephradine group and MG group. The decrement percent of RNS in gentamicin group [ (21.22 ± 4.63)% ], etimicin group[ (19.08 ±4. 25)% ], ciprofloxacin group[ (22.25 ±4.95)% ] and fleroxacin group[ (21.71 ±4.99)% ] were higher than that in MG group[(15.75 ±2.22)% ], but no difference was found in the attenuation rate among cefuroxime group[(15.25 ±2. 87)% ],cephradine group[ ( 15.25 ± 3.30)% ] and MG group. The levels of AChRab in gentamicin, etimicin, ciprofloxacin and fleroxacin groups were also higher than that in MG group, but no difference was found among cefuroxime group, cephradine group and MG group.CONCLUSOIN: Aminoglycoside and fluoroquinolone antibiotics can aggravate the obstruction of NMJ transmission, and cephalosporin antibiotics have no obvious effect on the obstruction of NMJ transmission function in MG.

OBJECTIVE:To establish a good method for determining the dissolution rates of diclofenac sodium suppository METHODS:The dissolution method Ⅰ and Ⅱ of ChP(2000) were compared,the first derivative spectrophotometry was used and the parameters(T50,Td,m) obtained from these samples were brought for correlation analysis RESULTS:The dissolution rate of diclofenac sodium suppository from the dissolution method Ⅰ and Ⅱ were remarkably different,and the dissolution method Ⅱ was better than Ⅰ CONCLUSION:The method established by this study is suitable for the quality control of diclofenac sodium suppository,and the percentage of dissolution of diclofenac sodium suppository in 45min more than 80% is the standard of quality control