Objective:To analyze the application of antitoxin therapy in severe infant botulism.Methods:A retrospective analysis was conducted on 14 cases of severe infant botulism treated at 3 pediatric medical centers from July 2020 to August 2024. This study investigated antitoxin dosage, treatment duration, discontinuation criteria and adverse reactions.Results:A total of 14 cases (12 males and 2 females) were included, with an age of 5.0 (3.8, 7.0) months. Botulinum toxin typing revealed 10 cases of Type B, 2 cases of Type A and 2 untyped cases. The interval from symptom onset to antitoxin administration was 9.0 (6.0, 11.5) d. The initial dosage of type A antitoxin was 12 500 (10 000, 22 500) U, while type B was 5 000 (5 000, 5 000) U. The dosage was tapered in some cases after symptom improvement, the duration of treatment was 16.5 (9.8, 25.3) d. In total, 11 infants discontinued medications after improvement in muscle strength, while 3 infants discontinued treatment after obtaining negative results from fecal mouse bioassays. Adverse events were reported in 2 cases, both of which resulted in rash, and 1 case was complicated with anaphylactic shock. All the patients survived upon discharge with a follow-up period of 11 d to 3 years and 8 months. Totally 12 infants had fully recovered, while 2 infants were still recovering after discharge.Conclusion:Antitoxin therapy is a feasible and safe approach which showed favorable prognosis in severe infant botulism.

Objective:To analyze the application of antitoxin therapy in severe infant botulism.Methods:A retrospective analysis was conducted on 14 cases of severe infant botulism treated at 3 pediatric medical centers from July 2020 to August 2024. This study investigated antitoxin dosage, treatment duration, discontinuation criteria and adverse reactions.Results:A total of 14 cases (12 males and 2 females) were included, with an age of 5.0 (3.8, 7.0) months. Botulinum toxin typing revealed 10 cases of Type B, 2 cases of Type A and 2 untyped cases. The interval from symptom onset to antitoxin administration was 9.0 (6.0, 11.5) d. The initial dosage of type A antitoxin was 12 500 (10 000, 22 500) U, while type B was 5 000 (5 000, 5 000) U. The dosage was tapered in some cases after symptom improvement, the duration of treatment was 16.5 (9.8, 25.3) d. In total, 11 infants discontinued medications after improvement in muscle strength, while 3 infants discontinued treatment after obtaining negative results from fecal mouse bioassays. Adverse events were reported in 2 cases, both of which resulted in rash, and 1 case was complicated with anaphylactic shock. All the patients survived upon discharge with a follow-up period of 11 d to 3 years and 8 months. Totally 12 infants had fully recovered, while 2 infants were still recovering after discharge.Conclusion:Antitoxin therapy is a feasible and safe approach which showed favorable prognosis in severe infant botulism.

Objective:To explore the application value of multi-slice spiral CT combined with carbohydrate antigen 125 (CA125) and alpha fetoprotein (AFP) in preoperative lymph node staging of rectal cancer.Methods:A retrospective case series study was performed. The clinical data of 90 patients with rectal cancer confirmed by pathology after operation at Haian Traditional Chinese Medicine Hospital from August 2020 to August 2022 were retrospectively analyzed. Multi-slice spiral CT was used to judge the diagnostic consistency between preoperative N stage and pathological N stage. The levels of serum CA125 and AFP in patients with different pathological N stages (N 0 stage, N 1 stage, N 2 stage) were compared. Taking postoperative pathological results as the gold standard, logistic regression was used to analyze the correlation between multi-slice spiral CT, CA125, and AFP with lymph node metastasis in rectal cancer. The receiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic efficacy of multi-slice spiral CT combined with CA125 and AFP for lymph node metastasis. Results:The pathological staging results showed that there were 44 cases in N 0 stage, 33 cases in N 1 stage, and 13 cases in N 2 stage. Multi-slice spiral CT staging results showed that there were 49 cases in N 0 stage, 26 cases in N 1 stage, and 15 cases in N 2 stage. The consistency between pathological staging and multi-slice spiral CT staging occurred in 34 cases in N 0 stage, 15 cases in N 1 stage and 5 cases in N 2 stage. The serum CA125 level in the pathological N 0, N 1, and N 2 stages groups was (15.8±1.4) U/ml, (38.9±2.4) U/ml, and (85.4±3.3) U/ml, respectively, and the difference was statistically significant ( F = 5 519.47, P< 0.05). The AFP level was (37.8±2.5) ng/ml, (79.3±4.6) ng/ml, and (168.3±5.9) ng/ml, respectively, and the difference was statistically significant ( F = 5 583.80, P < 0.05). Logistic regression analysis showed that N staging ( OR = 6.231,95% CI: 2.164-17.939, P = 0.001) and AFP ( OR = 1.020, 95% CI: 1.002-1.039, P = 0.032) were independent factors influencing the metastasis of lymph node in rectal cancer patients. ROC curve analysis showed that the area under the curve of AFP, CA125, multi-slice spiral CT, and the combination of the 3 in the diagnosis of lymph node metastasis was 0.850, 0.731, 0.745, and 0.912, respectively. Conclusions:Multi-slice spiral CT combined with serum CA125 and AFP has a high value in the diagnosis of preoperative lymph node staging of rectal cancer.

Objective:To explore changes in high-risk sexual behaviors and associated factors in HIV-infected men who have sex with men (MSM) in industrial workers, and provide evidence for designing behavioral interventions for this population.Methods:In this observational study, HIV-infected MSM were recruited in industrial workers using convenient sampling during August to September 2021. The sample size was estimated to be 530. A questionnaire was used and combined with routine follow-up to collect socio-demographic characteristics, high-risk sexual behaviors, partner notification, viral load testing and history of sexually transmitted diseases before and after diagnosis of HIV infection. The χ2 test was used to analyze the changes in high-risk sexual behaviors before and after diagnosis and logistic regression was conducted to identify factors associated with high-risk sexual behaviors. Results:A total of 560 HIV-infected MSM in industrial workers were recruited in this study. Of whom, 32.1% (180/560) had unprotected anal intercourse (UAI) within 12 months after diagnosis . The proportions of those having UAI with casual, commercial and regular same-sex partners significantly decreased from 73.4% (381/519), 75.1% (187/249) and 69.5% (207/298) within 12 months before diagnosis to 36.2% (146/403), 40.2% (86/214) and 34.2% (67/196) within 12 months after diagnosis , respectively. Educational level of college or above (a OR=0.41, 95% CI:0.23-0.71), passive anal sex (a OR=0.40, 95% CI:0.19-0.85), both active and passive anal sex after diagnosis (a OR=0.40, 95% CI:0.20-0.83) and no unprotected oral sex (a OR=0.02, 95% CI:0.01-0.05) were negatively associated with UAI within 12 months after diagnosis. Whereas, not considering necessary to use condom consistently after having repeated undetectable viral load (a OR=3.02, 95% CI:1.37-6.69) was positively associated with UAI within 12 months after diagnosis. Conclusions:Compared with that before diagnosis of HIV infection, although the prevalence of UAI seemed to decrease in HIV-infected MSM in industrial workers after diagnosis, nearly one third of them had high-risk sexual behaviors. Therefore, relevant interventions should be strengthened to reduce high-risk sexual behaviors.

Objective:To explore the cognition of the "undetectable equals untransmittable" ("U=U") concept and associated factors among HIV-infected men who have sex with men (MSM) receiving antiviral treatment (ART) in Shenzhen, and provide evidence for designing promotion and advocacy strategies for the "U=U" concept.Methods:We recruited HIV-infected MSM receiving ART using convenient sampling method combined with routine follow-up in Shenzhen through conducting observational survey. The sample size was estimated to be 475. A questionnaire was administered to collect socio-demographic characteristics, sexual behaviors, ART, viral load testing and the cognition towards "U=U" in HIV-infected MSM. Logistic regression was used to access factors associated with acceptance of "U=U".Results:A total of 490 HIV-infected MSM receiving ART were recruited. Of whom, 60.2% (295/490) were aware of "U=U" and 50.6% (248/490) accepted "U=U". Multiple logistic regression showed that participants who had an educational level of college or above (a OR=1.76,95% CI: 1.12-2.75) were more likely to accept "U=U". Those who had no local residency (a OR=0.51,95% CI: 0.29-0.92), had viral load >0 copies/ml in the last testing (a OR=0.61,95% CI: 0.38-0.98) and were unaware of "U=U" (a OR=0.13, 95% CI: 0.09-0.21), were less likely to accept "U=U". Conclusions:HIV-infected MSM receiving ART had a low cognition level of "U=U" in Shenzhen. Promotion and advocacy on this concept through healthcare workers should be enhanced in combination with routine follow-up in order to improve their ART adherence and outcome of treatment. Furthermore, developing related guidelines on "U=U" according to the characteristics of HIV-infected individuals is warranted to improve the normalization of promotion and advocacy on "U=U".

Objective To investigate the clinical characteristics, TCM syndrome differen tiation and short_term prognosis of painless acute myocardiac infarction (AMI). Methods Restrospective analysis was carried out in 32 patients with painless AMI (Group A) and 30 cases of painful AMI in the same period served as Group B. Results In Group A, clinical manifestations were latent, infarct places mai nly located in the inferior wall, right ventricle and posterior wall of the hear t ( 65.6% ), and yang_Qi deficiency syndrome and Qi_yin defic iency syndrome occupied 65.6% of painless AMI. Blood stasis syn drome and phlegm syndrome occupied 70.0% of painful AMI. The co ncurrent incidence of diabetes mellitus was higher in Group A than Group B. So d id the mortality and the incidence of heart failure. Cardiogenic shock and heart failure were the main death causes of painless AMI. Conclusion The above r esults will supply evidence for the combined treatment of painless AMI.