Purpose To explore the clinicopathological features of cholangitis lenta.Methods The clinical data of 12 patients with cholangitis Lenta were collected,HE staining,his-tochemical staining and immunohistochemistry were used to de-tect the clinicopathological changes in 12 cases of cholangitis lenta,and the relevant literature was reviewed.Results All the 12 patients with cholangitis Lenta had acute history and ab-normal liver function,9 cases(75.0％)had abnormal white blood cell count,11 cases(91.7％)had abdominal infection,8 cases(66.7％)had systemic inflammatory response syndrome(SIRS)and 8 cases(66.7％)were diagnosed as sepsis.The common pathological manifestations included spotty necrosis(100％),piecemeal necrosis(100％),confluent necrosis(75.0％),bridging necrosis(66.7％),hepatocyte and capil-lary cholestasis(75.0％),and mild edema in portal area(33.3％).12 cases showed proliferation of bile ductules around the portal area,inspissated bile in dilated bile ductules and no cholestasis in interlobular bile ducts.12 cases had the basis of primary liver disease.2 patients(16.7％)died after being transferred to another hospital for treatment,and 10 patients(83.3％)survived,which lasted for 7 to 55 months.Conclu-sion Cholangitis Lenta shows unique clinical manifestations and morphological features,it is often accompanied by underly-ing diseases.The pathological manifestation of cholangitis Lenta in liver biopsy suggests that patients may have sepsis and/or ab-dominal infection,and therefore its diagnosis should be com-bined with clinical features,laboratory examination and imaging manifestations.

Objective To explore the relationship between the variability of blood pressure and the occurrence of acute kidney injury(AKI)in patients with hypovolemic shock so as to provide a theoretical basis for early prediction and prevention of AKI.Methods Clinical data of 661 critically ill patients with hypovolemic shock were acquired from the Medical Information Mart for Intensive Care Ⅳ(MIMIC-Ⅳ)database from 2008 to 2022.Data were grouped with the quartile division method,with systolic blood pressure average real variability(SBP-ARV)and diastolic blood pressure average real variability(DBP-ARV)as the continuous or categorical variables.Univariate and multivariate logistic regression analyses were used to examine the relationships of SBP-ARV and DBP-ARV with the occurrence of AKI.Additionally,the relationship between SBP-ARV and the occurrence of AKI was further investigated in subgroups of gender,age,sequential organ failure assessment(SOFA),hypertension,diabetes,and the use of vasopressors after correction of all covariates.Results Logistic regression analysis showed that SBP-ARV,a continuous variable,was independently associated with the occurrence of AKI[OR(95%CI):1.05(1.01～1.10),P=0.024].However,DBP-ARV was not significantly related to the occurrence of AKI.When SBP-ARV was grouped by quartile division,Q4 group had a significantly higher risk of AKI[OR(95%CI):1.83(1.04～3.22),P=0.037]compared with that of Q1 group.Analyses across the subgroups revealed that there was an interaction between SBP-ARV and diabetes(P=0.033).Conclusion For ICU patients with hypovolemic shock,SBP-ARV positively associates with the occurrence of AKI.

Objective To explore the relationship between the variability of blood pressure and the occurrence of acute kidney injury(AKI)in patients with hypovolemic shock so as to provide a theoretical basis for early prediction and prevention of AKI.Methods Clinical data of 661 critically ill patients with hypovolemic shock were acquired from the Medical Information Mart for Intensive Care Ⅳ(MIMIC-Ⅳ)database from 2008 to 2022.Data were grouped with the quartile division method,with systolic blood pressure average real variability(SBP-ARV)and diastolic blood pressure average real variability(DBP-ARV)as the continuous or categorical variables.Univariate and multivariate logistic regression analyses were used to examine the relationships of SBP-ARV and DBP-ARV with the occurrence of AKI.Additionally,the relationship between SBP-ARV and the occurrence of AKI was further investigated in subgroups of gender,age,sequential organ failure assessment(SOFA),hypertension,diabetes,and the use of vasopressors after correction of all covariates.Results Logistic regression analysis showed that SBP-ARV,a continuous variable,was independently associated with the occurrence of AKI[OR(95%CI):1.05(1.01～1.10),P=0.024].However,DBP-ARV was not significantly related to the occurrence of AKI.When SBP-ARV was grouped by quartile division,Q4 group had a significantly higher risk of AKI[OR(95%CI):1.83(1.04～3.22),P=0.037]compared with that of Q1 group.Analyses across the subgroups revealed that there was an interaction between SBP-ARV and diabetes(P=0.033).Conclusion For ICU patients with hypovolemic shock,SBP-ARV positively associates with the occurrence of AKI.

Objective To investigate the application value of pre-implantation genetic testing(PGT)in patients with Turner syndrome.Methods The clinical data,embryonic development,PGT results and pregnancy outcome of 18 patients with Turner syndrome who underwent PGT in the reproductive center of 900th Hospital from January 2016 to June 2023 were retrospectively analyzed.Results All 18 patients had spontaneous puberty development,of which 4 patients had primary ovarian insufficiency(POI).A total of 24 oocyte retrieval cycles were performed in 18 patients,of which 6 patients had no biopsied embryos for 10 cycles.Sixty-one embryos were biopsied and 60 embryos were clearly diagnosed,including 25 with chromosomal abnormalities.Seven patients with mosaic Turner syndrome obtained clinical pregnancies after transplantation,including 4 healthy boys had already been delivered and 3 are in pregnancy.Conclusion There are numerous types of karyotype in Turner syndrome.The clinical phenotypes vary greatly in individuals with Turner syndrome,and prognosis of PGT is significant different.Patients with Turner syndrome who had biopsied embryos can obtain available embryo using PGT,and achieve ideal clinical outcomes.

Objective To analyze the epidemiological characteristics and drug resistance of pathogenic bacteria in 276 hospitalized children with lower respiratory tract infection to facilitate prevention and treatment. Methods Among of 276 hospitalized children with lower respiratory tract infection from January 2019 to December 2021 were analyzed. Data on the distribution of pathogenic bacteria were collected and analyzed. At the same time, the information on drug resistance was collected, and the potential relationship between pathogen distribution and drug resistance was briefly analyzed and discussed. Results A total of 532 strains of pathogenic bacteria were detected in the blood samples from 276 patients in this study. There were 207 strains of Gram-positive bacteria, including 104 strains of Staphylococcus aureus, 96 strains of Staphylococcus epidermidis and 7 strains of others. Gram negative bacteria (325 strains) were 172 strains of Klebsiella and 153 strains of Escherichia coli. The distribution of pathogenic bacteria in different gender and age groups (under 5 years old, 5-10 years old, and over 10 -14 years old) was calculated separately. The results showed that the distribution of pathogenic bacteria in female children under 5 years old (n=49 cases) was different from the total population: the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis was the highest (P<0.05). The distribution characteristics of children of other ages and sexes were consistent with the total distribution characteristics. The resistance rate of Gram-positive bacteria to penicillin, erythromycin and clarithromycin was high, while the resistance rate of Gram-negative bacteria to ampicillin, cefazolin and cefuroxime was high. The distribution characteristics were the same in children of different sex and age. Conclusion The pathogenic bacteria in children with lower respiratory tract infection in pediatric ward are mainly Gram-negative bacteria, and the main pathogenic bacteria have a high resistance rate to common drugs. The distribution of pathogenic bacteria in female children under 5 years old is unique: the infection of Gram-positive bacteria is higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis is the highest, which deserves attention. The clinical drug sensitivity test can be used as an important reference for the treatment of drugs to guide the rational selection of antibiotics.

OBJECTIVE: To assess the application value of mapping allele with resolved carrier status (MaReCs) technique for preimplantation genetic testing (PGT). METHODS: The characteristics of MaReCs for PGT and outcome of patients were retrospectively analyzed. RESULTS: Compared with those who could not use the technique, carriers who have used the MaReCs technique were younger, had significantly higher level of anti-Mullerian hormone, more antral follicles, occytes, mature occytes, biopsied embryos and euploid embryos, and lower risks for de novo chromosomal abnormality (P<0.05). It was necessary for couples with fewer oocytes, mature oocytes and balstocyst to preserve discarded embryos to facilitate the test. Carriers who have used the MaReCs technique had higher clinical pregnancy rate and abortion rate compared with those undergoing routine PGT, albeit no significant difference was found between the two groups (P> 0.05). Carriers undergoing MaReCs test could preferentially select embryos with normal chromosome structures for the transfer. CONCLUSION Application of MaReCs has a prerequisite for having a minimum number of occytes and biopsied embryos and using discarded embryos sometimes. MaReCs is efficient for the detection of carrier status of embryos and attaining higher rate of pregnancy and live birth, which can significantly improve the outcome for couples carrying chromosomal translocations.
Alleles ; Aneuploidy ; Blastocyst ; Female ; Fertilization in Vitro ; Genetic Testing ; Humans ; Pregnancy ; Preimplantation Diagnosis ; Retrospective Studies ; Translocation, Genetic

Objective To assess the association between-426C＞T,-384A＞G,+ 67G＞A polymorphisms in Eotaxin gene and cow's milk protein allergy (CMPA) in infants.Methods One hundred and six patients with CMPA who were hospitalized at Children's Hospital Affiliated to Nanjing Medical University from July 2014 to July 2015 were selected as CMPA group,and 124 healthy infants chosen from Ninghai Road Community Health Service Centers at the same time were selected as healthy control group,and the serum levels of Eotaxin in 2 groups were measured by enzyme-linked immunosorbent assay (ELISA),polymerase chain reaction (PCR) and DNA direct sequencing technology were used to detect the genotypes for single nucleotide polymorphisms (SNPs) of-426C ＞ T,-384A ＞ G,and + 67G ＞ A in Eotaxin gene.The association between the SNPs of-426C ＞ T,-384A ＞ G,and + 67G ＞ A in Eotaxin gene and CMPA,the peripheral blood eosinophil counts,serum Eotaxin levels,and serum total immunoglobulin E levels were analyzed.Results For-426C ＞ T,the frequency of each genotype of the CMPA group was CC,CT,TF (79.25％,19.81％,0.94％),while the frequency of each genotype of the healthy control group was CC,CT,TT(88.71％,8.06％,3.23％).There was a significant difference in the genotype frequency in-426C ＞ T between the CMPA group and the healthy control group (x2 =7.83,P ＜ 0.05).The individuals with heterozygous genotype(CT) had a 1.75-fold increased risk of developing CMPA compared with the individuals with wild-type genotype (CC) [odds ratio (OR) =2.75,95％ confidence interval(CI):1.23-6.15,P ＜ 0.05].For position + 67G ＞ A,CMPA patients with a genotype including variant nucleotide had lower peripheral blood eosinophil counts [(0.48 ± 0.06) × 109/L] and serum Eotaxin levels [(157.67 ± 12.72) ng/L] than those with wild-type genotype [(0.85 ± 0.09) × 109/L,(286.96 ± 33.23) ng/L] (F =10.30,5.75,all P ＜ 0.05).Conclusions Polymorphism of the Eotaxin gene (-426C ＞ T) was associated with the susceptibility to CMPA.Polymorphism of the Eotaxin gene(+ 67G ＞ A) was related to the blood eosinophil counts and the serum Eotaxin levels in children with CMPA.

Objective To investigate the effect of first aid nursing path under the center of chest pain on the diagnosis and treatment of patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 79 cases of STEMI patients who had been selected for emergency treatment after the establishment of the chest pain center were as the experimental group. The patient's first aid nursing path was used in the center of chest pain. A total of 159 cases of STEMI patients before the establishment of the chest pain center were as the control group, Application of traditional clinical pathway. Compared to the diagnosis and treatment effect of two groups of patients. Results The rate of completed the project within 10 min for the experimental group: the completion of electrocardiogram examination (91.1% vs 84.9% ), oral aspirin, clopidogrel, or lindinda (81.0% vs 75.5%), and laboratory medical order (79.7% vs 69.8%) were higher than those in the control group, and the difference was statistically significant (χ2=2.31, 1.68, 2.06, P < 0.05). The day of hospitalization in the experimental group was less than that of the control group (6.48±3.82 vs 9.76± 4.32), and the difference was statistically significant (t=-9.80, P < 0.05). The mortality rate during hospitalization was lower than that of the control group (5.66% vs 3.8% ), and the difference was statistically significant (χ2=-2.24, P<0.05). Conclusion The first aid nursing path in the center of chest pain can shorten the time of diagnosis and treatment of STEMI patients and improve the diagnosis and treatment effect of STEMI patients.

OBJECTIVE: To explore the effect of chromosomal translocations on the composition of embryonic chromosomes and its mechanism. METHODS: For 52 couples with one partner carrying a chromosomal translocation, results of next generation sequencing of all embryos derived from 61 cycles were divided into different groups based on the type of translocations, gender of the carrier, and maternal age. Effect of parental chromosomal translocations on the composition of embryonic chromosomes of each group was analyzed. RESULTS: A significant difference was found between carriers of reciprocal and Robertsonian translocations in terms of proportion of abnormal embryos and structurally normal chromosomes (63.3% vs. 27.5%, and 1.1% vs. 0.3%, respectively). Compared with male carriers, there was an increase in the rate of abnormalities for female carriers (67.2% vs. 58.3% for reciprocal translocations, and 45.5% vs. 13.8% for Robertsonian translocations). The risk for chromosomal abnormality also increased with the maternal age. No significant difference was found in the proportion of abnormal embryos between carriers divided by involvement of acrocentric chromosomes or terminal chromosomal breakpoints. CONCLUSION The types of parental translocation, gender of carrier, maternal age, and interchromosomal effect have certain effect on the composition of embryonic chromosomes.
Chromosomes, Human ; genetics ; Female ; Genetic Carrier Screening ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Maternal Age ; Pregnancy ; Preimplantation Diagnosis ; Translocation, Genetic

Objective To evaluate combined sampling at multiple sites of gastric mucosa for Helicobacter pylori (HP) culture.Methods A total of 258 patients with upper gastrointestinal symptoms received 13C-urea breath test between August 2014 and May 2015.During endoscopy,gastric mucosa biopsy samples from the lesser curvature of the antrum (A),the greater curvature of the antrum (B),gastric angle (C) and the body of the stomach (D) were collected to isolate HP strains.The positive rates of HP based on combined sampling and single site sampling were compared with a Nemenyi test.Results Consistency between 13C-urea breath test and HP culture was 82.56％.There was significant difference between the single site sampling and two-site sampling in the positive rate of HP,except for the body of the stomach (P＜0.05).There was significant difference in the positive rate of HP between the single site sampling and three-site sampling (P ＜ 0.05).There was no significant difference between any two-site sampling in the lesser curvature of the antrum and the body of the stomach,gastric angle and the body of the stomach,the greater curvature of the antrum and the body of the stomach,and any three-site sampling (P＞0.05).Conclusion The combined sampling of the lesser curvature of the antrum and the body of the stomach have the highest cost-effectiveness in HP culture compared with the single site sampling and three-site sampling.