Objective:To analyze the clinical characteristics and outcomes of Haemophilus influenzae (Hi) meningitis in children. Methods:This is a retrospective case series study. This study included 34 Hi meningitis patients who admitted to Beijing Children′s Hospital, Capital Medical University, from January 1, 2010, to December 31, 2023. Data on clinical presentations, laboratory tests, hearing assessment and outcomes at discharge were collected. Patients were divided into 2 groups according to the outcome at discharge: favorable outcome group and unfavorable outcome group. Mann-Whitney U test and Fisher exact test was used to estimate the risk factors for an unfavorable outcome at discharge. Results:Thirty-four patients were enrolled. There were 16 males and 18 females. The age at onset ranged from 3 months to 12 years. Fever (34 patients (100%)), convulsions (17 patients (50%)), and coma (21 patients (62%)) were the common clinical presentations. Twenty-four patients (71%) developed complications. There were 15 patients (44%) needed treatment in the intensive care unit, 5 patients (15%) received intubation, and 4 patients (12%) had developed shock. The favorable outcome group included 23 patients, and the unfavorable outcome group included 11 patients. Female, patients with limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L were risk factors of unfavorable outcome at discharge (all P<0.05). Among the 23 patients (68%) in favorable outcomes group, 13 patients (57%) had data available on their long-term follow-up results, including 12 patients with favorable long-term outcomes and 1 patient with unfavorable long-term outcome. Among the 11 patients (32%) in unfavorable outcomegroup, 1 patient died, the other 10 patients (91%) had data available on their long-term outcomes. Eight patients had unfavorable long-term outcomes and 2 patients with favorable long-term outcomes. Patients who had unfavorable outcomes at discharge were at a greater risk of experiencing unfavorable long-term outcomes ( P=0.001). Conclusions:It is common for patients with Hi meningitis to have intracranial complications or develop into critical conditions. Patients who have limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and who exhibit a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L tend to have unfavorable outcomes; they need to be assessed for sequelae.

Objective To explore the application value of turbo spin echo-diffusion weighted imaging(TSE-DWI)sequences in 3.0 T rectal cancer MRI examination by comparing the image quality difference be-tween TSE-DWI and conventional echo planar imaging-diffusion weighted imaging(EPI-DWI)sequences.Methods The medical records of forty-two patients with newly diagnosed rectal cancer confirmed by colonos-copy were prospectively collected.All patients simultaneously underwent both TSE-DWI and EPI-DWI se-quence scans.The image quality of the two groups performed the subjective evaluation(lesion contrast,mag-netic susceptibility artifacts,geometric distortion)and objective evaluation[signal-to-noise ratio(SNR),con-trast-to-noise ratio(CNR),contrast,etc].Results In the subjective evaluation,compared with the conven-tional EPI-DWI sequences,the proportions of subjective score 3-5 points for the lesion contrast,magnetic susceptibility artifacts and geometric distortion in the TSE-DWI sequences lesions were over 95％,which all were higher the conventional EPI-DWI sequences;among them,the differences in the subjective scoring results of magnetic susceptibility artifacts and geometric deformation were statistically significant(x2=12.464,5.610,P＜0.05),while there was no statistical significance in lesion contrast(x2=2.363,P＞0.05).In the objective evaluation,SNR and CNR in the TSE-DWI sequences all were higher than those in the conventional EPI-DWI sequences,in which the difference in CNR was statistically significant(Z=—5.645,P＜0.05),while the difference in SNR was not statistically significant(Z=—1.057,P＞0.05).The contrast in the TSE-DWI sequences was lower than that in the conventional EPI-DWI sequences,and the difference was statistical-ly significant(t=3.012,P＜0.05).Conclusion The TSE-DWI sequence images have small geometric de-formation and few magnetic susceptibility artifacts,the image quality is superior to the EPI-DWI sequences.Especially in 3.0T rectal cancer MRI plain scan,the patients with gas accumulation in the intestinal lumen of rectal lesion could directly adopt the TSE-DWI sequences by replacing the conventional EPI-DWI sequences in order to increase the clinical application efficiency and image quality.

Objective:To analyze the clinical characteristics and outcomes of Haemophilus influenzae (Hi) meningitis in children. Methods:This is a retrospective case series study. This study included 34 Hi meningitis patients who admitted to Beijing Children′s Hospital, Capital Medical University, from January 1, 2010, to December 31, 2023. Data on clinical presentations, laboratory tests, hearing assessment and outcomes at discharge were collected. Patients were divided into 2 groups according to the outcome at discharge: favorable outcome group and unfavorable outcome group. Mann-Whitney U test and Fisher exact test was used to estimate the risk factors for an unfavorable outcome at discharge. Results:Thirty-four patients were enrolled. There were 16 males and 18 females. The age at onset ranged from 3 months to 12 years. Fever (34 patients (100%)), convulsions (17 patients (50%)), and coma (21 patients (62%)) were the common clinical presentations. Twenty-four patients (71%) developed complications. There were 15 patients (44%) needed treatment in the intensive care unit, 5 patients (15%) received intubation, and 4 patients (12%) had developed shock. The favorable outcome group included 23 patients, and the unfavorable outcome group included 11 patients. Female, patients with limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L were risk factors of unfavorable outcome at discharge (all P<0.05). Among the 23 patients (68%) in favorable outcomes group, 13 patients (57%) had data available on their long-term follow-up results, including 12 patients with favorable long-term outcomes and 1 patient with unfavorable long-term outcome. Among the 11 patients (32%) in unfavorable outcomegroup, 1 patient died, the other 10 patients (91%) had data available on their long-term outcomes. Eight patients had unfavorable long-term outcomes and 2 patients with favorable long-term outcomes. Patients who had unfavorable outcomes at discharge were at a greater risk of experiencing unfavorable long-term outcomes ( P=0.001). Conclusions:It is common for patients with Hi meningitis to have intracranial complications or develop into critical conditions. Patients who have limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and who exhibit a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L tend to have unfavorable outcomes; they need to be assessed for sequelae.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective:To investigate the myocardial protective effect of extracorporeal cardiac shock wave therapy (CSWT) combined with sulfur hexafluoride microbubble post-conditioning on myocardial ischemia-reperfusion injury (MI/RI) in rats, and to provide theoretical support for clinical treatment of MI/RI.Methods:A total of 32 male SD rats were randomly divided into 4 groups: sham operation group (Sham group), MI/RI group (IR group), CSWT group (IR+ SW group), and CSWT combined with sulfur hexafluoride microbubble treatment group (IR+ SW+ MB group), with 8 rats in each group. Therapeutic intervention was performed in IR+ SW group and IR+ SW+ MB group on the 1st, 3rd and 5th day after modeling. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) of the rats were measured by echocardiography before and after treatment. On the 7th day, myocardial fibrosis was assessed by Masson staining, and cardiomyocyte apoptosis was observed by TUNEL staining. The myocardial apoptotic proteins Bcl-2, BAX, Cleaved-Caspase-3 and Cleaved-Caspase-9 in the infarct boundary area were detected by Western blot. The differences of the above indexes among different groups were compared.Results:①There was no significant change in heart rhythm and heart rate among the groups before and after treatment, and there was no significant difference in heart rate ( P>0.05). ②The echocardiographic results after treatment showed that, compared with IR group, LVEDD and LVESD in IR+ SW group and IR+ SW+ MB group decreased in turn, while LVEF and LVFS increased in turn with significant differences between each two groups (all P<0.05). ③Compared with IR group, the degrees of myocardial fibrosis and apoptosis in IR+ SW group and IR+ SW+ MB group were alleviated in turn, and the relief in IR+ SW+ MB group was the most obvious. Quantitative analysis showed that compared with IR group, the proportions of cardiomyocyte apoptosis in IR+ SW group and IR+ SW+ MB group decreased in turn, and there were significant differences between each two groups (all P<0.05). ④The results of Western blot detection showed that compared with IR group, the levels of Bcl-2 in IR+ SW group and IR+ SW+ MB group increased in turn, while the levels of BAX and the activation level of Caspase-3 and Caspase-9 protein decreased in turn. These differences were all statistically significant between each two groups (all P<0.05) except for the activation level of Caspase-3 protein between IR+ SW group and IR+ SW+ MB group ( P>0.05). Conclusions:CSWT combined with sulfur hexafluoride microbubble therapy can improve left ventricular remodeling and left ventricular systolic function by inhibiting cardiomyocyte apoptosis.

Objective: To evaluate the distribution characteristics and health risk of trichloromethane (TCM) in the drinking water supply of primary and middle schools in rural areas of Tianjin, so as to provide a scientific basis for improving drinking water safety in rural schools. Methods: A total of 60 water samples from 30 rural primary and middle schools in 10 agricultural districts of Tianjin were collected from April to June (dry season) and July to October (wet season) in 2023 with direct selection method. The content of TCM was detected according to the Standard Methods for the Examination of Drinking Water, and a risk assessment method recommended by the United States Environmental Protection Agency was used to evaluate the health risk of TCM through oral exposure. Results: The concentration of TCM in drinking water was no detection to 54.00 μg/L, with an average of (13.44±14.88) μg/L, and the value was higher during the wet season [12.90(1.40,32.28)μg/L] than the dry season [2.40(1.40,18.13)μg/L] (Z=-2.09, P<0.05). The concentration of TCM for primary and middle schools were [3.38(1.40,20.75) μg/L] and [5.30(1.40,28.23)μg/L] respectively, and there was no statistically significant difference between different types of schools (Z=0.50, P>0.05). The carcinogenic risk through oral exposure ranged from 3.84×10-7 to 2.05×10-5, while the noncarcinogenic risk ranged from (0.00-0.16), all within the acceptable range. Children aged 6 to 9 years old were at the highest risk. Conclusions TCM has been detected in the drinking water of rural primary and middle schools to a certain extent in Tianjin, and attention should be paid to the potential health risks of oral exposure. The monitoring and management of disinfection byproducts in drinking water should be strengthened to further reduce the risk of exposure to children.

Multidrug resistance （MDR） has been a main culprit behind the failure of chemotherapy in patients with malignant tumors and a major obstacle to improving the life quality and prolonging the survival of patients. Hepatocellular carcinoma cells， the innate drug-resistant cells， are generally insensitive to radiotherapy and chemotherapy. Moreover， as the early symptoms of hepatocellular carcinoma are atypical， most patients are diagnosed at the advanced stage， with short survival period and high recurrence rate. Thus， the sensitivity to chemotherapy drugs is decreased. This explains how MDR becomes one of the important reasons for the failure of primary hepatocellular carcinoma （PHC） treatment. Therefore， it is an urgent task to search for safe and effective chemosensitizers with little adverse effect in the research on the drug resistance of hepatocellular carcinoma. As Chinese medicine has been widely applied in the treatment of tumors， the mechanisms of compound Chinese medicine prescriptions， Chinese medicine injections， and single Chinese medicinal in reversing chemotherapy resistance in liver cancer have attracted the interest of scholars. According to previous reports， the mechanisms can be summarized as increasing intracellular drug concentration， influencing changes in enzyme activity， inducing apoptosis， reversing abnormalities in cellular signaling pathways， and regulating the tumor microenvironment. Traditional Chinese medicine reduces the chemotherapy resistance of hepatocellular carcinoma cells through multiple targets and multiple pathways， thereby improving the chemotherapy sensitivity of the cancer cells and enhancing the toxicity of chemotherapeutic drugs to hepatocellular carcinoma cells. Therefore， exploring the mechanism of MDR of hepatocellular carcinoma from the perspective of traditional Chinese medicine is important for reversing the MDR and is of great reference value for clinical treatment of hepatocellular carcinoma. However， there are few experimental types and adverse effects available. Thus， the multi-mechanism and multi-target experiments and clinical research should be carried out in the future.

Objective:To explore the feasibility of dual-energy CT (DECT) in the evaluation of liver iodine concentration in patients on long-term oral amiodarone treatment (≥12 months).Methods:Eighteen subjects undergoing abdominal dual-energy CT who met the criterion in January 2017 were collected as a control group. Twenty-seven patients who received oral amiodarone treatment for more than 12 months from January 2017 to May 2019 were enrolled as an experimental group. The difference of CT value and iodine concentration of liver, pancreas and spleen in 140 kV, 100 kV and VNC images between experimental and control groups were measured and analyzed. The correlation between liver CT value and liver iodine concentration was analyzed by Spearman correlation.Results:The concentrations of iodine in the liver, pancreas and spleen of the experimental group were 0.2 (0.2, 0.4), 0.1 (0.1, 0.2) and 0.2 (0.1, 0.2) mg/ml, and those in the control group were 0.2 (0.1， 0.2), 0.1 (0.1, 0.2) and 0.1 (0.1, 0.2) mg/ml. The difference in the concentration of iodine of the liver was statistically significant ( Z=-3.354, P<0.05), however there was no significant difference in the concentration of pancreas and spleen between the two groups ( Z=-0.179 and -1.590, P>0.05). The CT values of 100 kV, 140 kV, VNC images in the experimental group [(74±18)， (70±10) and (71±5) HU] were higher than those in the control group [(60±6)， (59±6) and (62±6) HU], and the differences were statistically significant ( t=3.310, 4.205 and 5.241, P<0.05). There was a positive correlation between the CT value of 140 kV image and iodine concentration ( r=0.410, P<0.05). In the experimental group, the time difference of taking amiodarone was statistically significant ( P<0.05). Conclusions:DECT can be used to quantitatively measure the liver iodine concentration of patients with long-term oral amiodarone, and provides some biological indicators for the assessment of amiodarone induced liver injury.

Objective To assess the diagnostic value of 3D-enhanced T2 ? weighted angiography (ESWAN )in evaluating superficial siderosis of the central nervous system (SS-CNS)after traumatic subarachnoid hemorrhage (tSAH).Methods ESWAN and GRE T2 ? WI sequence were performed on 30 patients with tSAH,detection rate and the number of distribution areas of SS-CNS were compared between the two sequences.A McNemar’s test and Wilcoxon signed-rank test were used to analyze the differences between T2 ? WI and ESWAN images sequences. Results In the tSAH group,29 of 30 patients (96.7%)showed SS-CNS on ESWAN images,the total number of SS-CNS regions was 134.Identified SS-CNS positive rate respectively was 95.8% (23/24)on ESWAN images and 66.7% (1 6/24)on T2 ? WI in 24 patients simultaneously perform ESWAN and T2 ? WI sequences.A McNemar ’s test showed that there was significant difference between the positive rates of two sequences in detecting the SS-CNS (χ2 =7.0,P <0.05).The number of SS-CNS regions on ESWAN images and T2 ? WI was 106 and 34 respectively.The Wilcoxon signed rank test showed that the number of SS-CNS regions difference between two sequences was significant (Z =-4.225,P <0.01).Conclusion Various degress of SS-CNS are detected in a majority of tSAH atients.ESWAN sequence is a reliable and efficient method for assessment of SS-CNS.

Objective To investigate the risk factors for drug resistance‐tuberculosis(DR‐TB) ,and to establish a clinical risk predictive model .Methods A total of 126 cases of DR‐TB patients and 126 cases of non‐DR‐TB patients treated in our hospital from January 2014 to January 2015 were included in this study .The clinical data of these patients were collected .We used univariate and multivariate logistic regression analysis to determine the independent risk factors and established a risk predictive model .The calibration and discrimination of the model were assessed by the H‐L test and the area under the ROC curve ,respectively .Results Statistical analysis showed that the risk factors included previous treatment ,a duration of first treatment of more than 8 months ,ad‐verse effects of anti‐TB medication ,more than three TB foci in the lung and diabetes mellitus .H‐L statistic(χ2 =8 .760 ,P=0 .363) . The area under the ROC was 0 .826 ,95% CI(0 .766 ,0 .886) .Conclusion Logistic regression model established in the study can pre‐dict the incidence of DR‐TB with high prediction accuracy .