Objective Varicella zoster virus(VZV)is a prevalent etiological agent of viral encephalitis/meningitis,and met-agenomic next generation sequencing(mNGS)has demonstrated its capability to rapidly and accurately diagnose VZV encephalitis/menin-gitis.However,there are limited studies investigating the prognostic value of mNGS sequence reads in cerebrospinal fluid(CSF)for VZV encephalitis/meningitis.In this study,we aimed to identify risk factors associated with poor prognosis in VZV encephalitis/meningitis pa-tients based on mNGS sequence reads,aiming to enhance clinical prediction.Methods A total of 54 patients diagnosed with VZV en-cephalitis,confirmed by cerebrospinal fluid mNGS,were selected from the Department of Neurology at Hengshui People's Hospital be-tween January 2016 and October 2022.Based on the Glasgow outcome scale(GOS)three months post-discharge,patients were catego-rized into a good prognosis group(26 cases)and a poor prognosis group(28 cases).The clinical features,auxiliary examinations,and prognostic outcomes of both groups were analyzed and summarized.Results Statistically significant differences were observed between the two groups in terms of diabetes prevalence,incidence of high fever,time interval between onset of neurological symptoms and initiation of antiviral treatment,leukocyte count in CSF,as well as the mNGS sequence reads(P＜0.05).Multivariate Logistic regression analysis re-vealed that a history of diabetes mellitus,elevated leukocyte levels in CSF,and higher number of VZV sequence reads detected by mNGS in CSF independently contributed to poor prognosis among patients with VZV encephalitis/meningitis(P＜0.05).Conclusion Patients with VZV encephalitis/meningitis who have comorbid diabetes mellitus along with higher leukocyte levels in CSF and increased mNGS se-quence reads exhibited worse prognoses three months after discharge.

Objective Varicella zoster virus(VZV)is a prevalent etiological agent of viral encephalitis/meningitis,and met-agenomic next generation sequencing(mNGS)has demonstrated its capability to rapidly and accurately diagnose VZV encephalitis/menin-gitis.However,there are limited studies investigating the prognostic value of mNGS sequence reads in cerebrospinal fluid(CSF)for VZV encephalitis/meningitis.In this study,we aimed to identify risk factors associated with poor prognosis in VZV encephalitis/meningitis pa-tients based on mNGS sequence reads,aiming to enhance clinical prediction.Methods A total of 54 patients diagnosed with VZV en-cephalitis,confirmed by cerebrospinal fluid mNGS,were selected from the Department of Neurology at Hengshui People's Hospital be-tween January 2016 and October 2022.Based on the Glasgow outcome scale(GOS)three months post-discharge,patients were catego-rized into a good prognosis group(26 cases)and a poor prognosis group(28 cases).The clinical features,auxiliary examinations,and prognostic outcomes of both groups were analyzed and summarized.Results Statistically significant differences were observed between the two groups in terms of diabetes prevalence,incidence of high fever,time interval between onset of neurological symptoms and initiation of antiviral treatment,leukocyte count in CSF,as well as the mNGS sequence reads(P＜0.05).Multivariate Logistic regression analysis re-vealed that a history of diabetes mellitus,elevated leukocyte levels in CSF,and higher number of VZV sequence reads detected by mNGS in CSF independently contributed to poor prognosis among patients with VZV encephalitis/meningitis(P＜0.05).Conclusion Patients with VZV encephalitis/meningitis who have comorbid diabetes mellitus along with higher leukocyte levels in CSF and increased mNGS se-quence reads exhibited worse prognoses three months after discharge.

Objective:To investigate the relations of clinical manifestations with sequence numbers detected in the cerebrospinal fluid of varicella-zoster virus (VZV) encephalitis/meningitis patients based on metagenomic next-generation sequencing (mNGS).Methods:Fifty-four VZV encephalitis/meningitis patients admitted to Department of Neurology, Harrison International Peace Hospital from January 2016 to October 2022 were selected. Sequence numbers of VZV in the cerebrospinal fluid of these patients were detected by mNGS; these patients were divided into low-detected sequence number group (≤1 000) and high-detected sequence number group (>1 000) accordingly. Differences in clinical manifestations, auxiliary examination results, treatments and prognoses were compared between the two groups.Results:Twenty-six patients were into low-detected sequence number group and 28 patients were into high-detected sequence number group. Compared with the low-detected sequence number group, the high-detected sequence number group had significantly older age (48.0 [35.5, 65.3] years vs. 63.0 [54.0, 71.8] years), higher proportion of patients using immunosuppressants (0.0% vs. 14.3%), lower proportion of those with meningeal irritation signs (46.2% vs. 17.9%), higher proportions of those with abnormal mental behaviors (15.4% vs. 42.9%), epilepsy (3.8% vs. 28.6%), and consciousness disorders (11.5% vs. 42.9%), greater cerebrospinal fluid pressure (150.0 [127.5, 177.5] mm H 2O vs. 185.0 [152.5, 210.0] mm H 2O), higher electroencephalogram positive rate (11.8% vs. 47.7%), and higher poor prognosis rate at discharge (26.9% vs. 66.7%, P<0.05). Conclusions:The clinical phenotype of the low-detected sequence number group tends to meningitis, while that of the high-detected sequence number group tends to encephalitis. Patients with high-detected sequence numbers have high cerebrospinal fluid pressure and abnormal electroencephalogram, enjoying poor prognosis.

Primary breast lymphoma (PBL) is a kind of rare primary extranodal lymphoma, which is of relatively poor prognosis and so far there is no unified treatment. In the case diagnosed by Our hospital where one patient recurring breast diffuse large B cell lymphoma (DLBCL) many times, has been treated with good therapeutic effect through surgery, chemotherapy, targeted drug therapy and radiotherapy. A multidisciplinary discussion is made concerning the treatment of the patient in this article for the purpose of further discussing the standard treatment procedure for PBL and promoting multi-disciplinary team.