This paper reported a central nervous system infection caused by Bacillus cereus in a neonate. The patient was born prematurely at 33 weeks of gestation and 1 day. He was transferred to Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, on October 5, 2022 (day 38 of life), due to recurrent fever. Multiple cerebrospinal fluid and head MRI examinations indicated purulent meningitis with abscesses formation, though repeated blood and cerebrospinal fluid cultures were negative. At 38 days of life, metagenomic next-generation sequencing of the cerebrospinal fluid pathogens revealed the presence of the Bacillus cereus group. The patient was treated with vancomycin followed by sequential linezolid for anti-infective therapy, leading to significant improvement. The patient was discharged on day 67 of life. Follow-up at 98 days of life showed improved head MRI findings and symptom resolution. At 2 years of age, telephone follow-up indicated normal growth and development with no abnormalities.

Objective To explore the clinical characteristics and prognosis of neonatal thalamic hemorrhage.Methods The clinical data of two neonates with thalamic hemorrhage admitted to Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were retrospectively analyzed.The terms"thalamic hemorrhage""neonate",and"newborn"were searched in the databases CNKI,Wanfang,CQVIP,PubMed,and Web of Science to summarize the reported etiology,clinical features,and prognosis of neonatal thalamic hemorrhage.Results Both cases were diagnosed with unilateral thalamic hemorrhage due to perinatal hypoxia.No seizures or other typical neurological abnormalities were observed.The patients improved after hemostatic and neuroprotective treatment and were discharged.They were followed up regularly until two years of age,with favorable outcomes.A total of 13 relevant studies involving 35 cases were included.Thalamic hemorrhage mostly occurred within the first two weeks of life(31/37 cases,83.78%).Bilateral thalamic hemorrhage accounted for 21.62%(8/37),primarily caused by perinatal asphyxia,while unilateral cases(78.38%,29/37)were mostly associated with cerebral venous sinus thrombosis.Infants with bilateral thalamic hemorrhage or associated ventricular dilatation presented with more severe symptoms,such as generalized tonic seizures,sunsetting sign,thermoregulatory instability,and absent neurological reflexes,and had significantly worse outcomes compared to unilateral cases(P=0.006).In long-term follow-up,42.34%(16/37 cases)exhibited normal neurodevelopment without major neuropsychiatric abnormalities.Among them,those with unilateral thalamic hemorrhage showed relatively better long-term prognosis.In addition,limited case analysis showed no statistically significant association between prognosis and gestational age,sex,time of onset,EEG findings,or status epilepticus.Conclusions The etiology and clinical presentation of neonatal thalamic hemorrhage are heterogeneous.The prognosis significantly differs between bilateral and unilateral hemorrhages.Long-term follow-up is essential to assess the impact on neurodevelopment and neurological function.

Objective To explore the clinical characteristics and prognosis of neonatal thalamic hemorrhage.Methods The clinical data of two neonates with thalamic hemorrhage admitted to Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were retrospectively analyzed.The terms"thalamic hemorrhage""neonate",and"newborn"were searched in the databases CNKI,Wanfang,CQVIP,PubMed,and Web of Science to summarize the reported etiology,clinical features,and prognosis of neonatal thalamic hemorrhage.Results Both cases were diagnosed with unilateral thalamic hemorrhage due to perinatal hypoxia.No seizures or other typical neurological abnormalities were observed.The patients improved after hemostatic and neuroprotective treatment and were discharged.They were followed up regularly until two years of age,with favorable outcomes.A total of 13 relevant studies involving 35 cases were included.Thalamic hemorrhage mostly occurred within the first two weeks of life(31/37 cases,83.78%).Bilateral thalamic hemorrhage accounted for 21.62%(8/37),primarily caused by perinatal asphyxia,while unilateral cases(78.38%,29/37)were mostly associated with cerebral venous sinus thrombosis.Infants with bilateral thalamic hemorrhage or associated ventricular dilatation presented with more severe symptoms,such as generalized tonic seizures,sunsetting sign,thermoregulatory instability,and absent neurological reflexes,and had significantly worse outcomes compared to unilateral cases(P=0.006).In long-term follow-up,42.34%(16/37 cases)exhibited normal neurodevelopment without major neuropsychiatric abnormalities.Among them,those with unilateral thalamic hemorrhage showed relatively better long-term prognosis.In addition,limited case analysis showed no statistically significant association between prognosis and gestational age,sex,time of onset,EEG findings,or status epilepticus.Conclusions The etiology and clinical presentation of neonatal thalamic hemorrhage are heterogeneous.The prognosis significantly differs between bilateral and unilateral hemorrhages.Long-term follow-up is essential to assess the impact on neurodevelopment and neurological function.

This paper reported a central nervous system infection caused by Bacillus cereus in a neonate. The patient was born prematurely at 33 weeks of gestation and 1 day. He was transferred to Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, on October 5, 2022 (day 38 of life), due to recurrent fever. Multiple cerebrospinal fluid and head MRI examinations indicated purulent meningitis with abscesses formation, though repeated blood and cerebrospinal fluid cultures were negative. At 38 days of life, metagenomic next-generation sequencing of the cerebrospinal fluid pathogens revealed the presence of the Bacillus cereus group. The patient was treated with vancomycin followed by sequential linezolid for anti-infective therapy, leading to significant improvement. The patient was discharged on day 67 of life. Follow-up at 98 days of life showed improved head MRI findings and symptom resolution. At 2 years of age, telephone follow-up indicated normal growth and development with no abnormalities.

Objective:To investigate the clinical characteristics of first-episode and recurrent acute hypertriglyceridemic pancreatitis (HTGP).Methods:The retrospective cohort study was con-ducted. The clinical data of 313 patients with HTGP admitted to 26 medical centers in China in the Chinese Acute Pancreatitis Clinical Research Group (CAPCTG)-PERFORM database from November 2020 to December 2021 were collected. There were 219 males and 94 females, aged 38(32,44)years. Of the 313 patients, 193 patients with first-episode HTGP were allocated into the first-episode group and 120 patients with recurrent HTGP were allocated into the recurrent group. Observation indica-tors: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) comparison of severity and prognosis in the course of disease within 14 days between the two groups; (3) the association between recurrent HTGP and the risk of persistent organ failure (POF); (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. The Kaplan-Meier method was used to plot the cumulative recurrence rate curve and Log-Rank test was used for survival analysis. The Logistic regression model was used for multivariate analysis, and continuous variables were converted into categorical variables according to the mean value or common criteria. Propensity score matching was performed by 1∶1 nearest neighbor matching method, with caliper value of 0.02. Paired t test or Wilcoxon rank sum test and McNemar′s test were used for comparison between matched groups. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 313 patients,208 cases were successfully matched, including 104 cases in the first-episode group and 104 cases in the recurrent group. After propensity score matching, there was no significant difference in demographic characteristics, severity of illness scores and laboratory test between the two groups ( P>0.05). The elimination of gender, acute physiology and chornic health evaluation (APACHE) Ⅱ score, computed tomography severity index score, systemic inflammatory response syndrome score, sequential organ failure assessment score, apolipoprotein E, C-reactive protein, creatinine, lactic acid dehydrogenase, procal-citonin confounding bias ensured comparability between the two groups. (2) Comparison of severity and prognosis in the course of disease within 14 days between the two groups. There were signifi-cant differences in POF and local complications between the first-episode group and the recurrent group ( P<0.05). (3) The association between recurrent HTGP and the risk of POF. Results of uncor-rected univariate analysis showed that there was no association between recurrent HTGP and the risk of POF ( odds ratio=0.78, 95% confidence interval as 0.46-1.30, P>0.05). Results of multivariate analysis after adjusting for covariates such as gender, age, APACHE Ⅱ score, C-reactive protein, triglyceride and total cholesterol showed that compared with first-episode HTGP, recurrent HTGP was associated with a higher risk of POF ( odds ratio=2.22, 95% confidence interval as 1.05-4.71, P<0.05). Results of subgroup analysis showed that age<40 years was associated with an increased risk of POF ( odds ratio=3.31, 95% confidence interval as 1.09-10.08, P<0.05). (4) Follow-up. Twelve of the 313 patients died during hospitalization, including 9 cases in the first-episode group and 3 cases in the recurrent group. The rest of 301 surviving patients, including 184 cases in the first-episode group and 117 cases in the recurrent group, were followed up for 19.2(15.5, 21.9)months. Results of follow-up showed that for 184 survived patients of the first-episode group, 164 cases were followed up and 24 cases experienced recurrence, for 117 survived patients of the recurrent group,29 cases experienced recurrence, showing a significant difference between the two groups ( χ2=4.67, P<0.05). Conclusion:Compared with first-episode HTGP, patients with recurrent HTGP are more prone to POF and local complications, and are more prone to recurrence after discharge. The risk of POF in recurrent HTGP patients is 2.22 times that of those with first-episode, and the risk is higher in patients with age <40 years.

Objective To investigate the application of gene panel in neonates with suspected genetic metabolic diseases.Methods The gene panel designed by Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology was used to screen newborns exhibiting high-risk clinical phenotypes of genetic metabolic diseases from January 2023 to March 2024.Meanwhile,the clinical data were collected and follow-up observations were conducted to analyze the detection rates of pathogenic genes and the correlation between genotype and phenotype of the neonates.Results A total of 53 neonates with high-risk inherited metabolic clinical phenotypes were included in this study,among which the overall positive detection rate for pathogenic genes was 17.0%(9/53).The pathogenic genes detected in this study were chloride channel(CLCN1),dual oxidase 2(DUOX2),gap junction protein beta 2(GJB2),tyrosine-protein phosphatase nonreceptor type 11(PTPN11),sodium channel α subunit(SCN1A),spastic paraplegia gene 11(SPG11),etc.DUOX2 and GJB2 were the most frequently detected,accounting for 33.3%(3/9)and 22.2%(2/9)of positive cases,respectively.A comparative analysis was made between the positive and negative groups of pathogenic genes,and it was found that the prognosis of the positive group was more serious and the number of clinical phenotypes might be more than that of the negative group.In the positive group of pathogenic genes,except for cases 1 and 9,whose clinical phenotypes were temporarily inconsistent with pathogenic genes due to the late onset of related diseases,the pathogenic genes were consistent with clinical phenotypes in the remaining cases.Conclusion The gene panel,characterized by short detection time,low detection cost and minimal technical demands,are suitable for the early screening of neonates with suspected genetic metabolic diseases in developing countries and economically backward areas.

Using machine learning algorithms to construct an early prediction model of brucellosis to improve the diagnosis efficiency of Brucellosis. This study was a case-control study. 2 381 brucellosis patients from Beijing Ditan Hospital affiliated to Capital Medical University were retrospectively collected as case group, and healthy people from Beijing Chaoyang Hospital affiliated to Capital Medical University were collected as control group from May 9, 2011 to November 29, 2021. The relevant clinical information and full blood count results of 13 257 data were collected and five algorithms of machine learning were used to construct an early predication model of brucellosis by using machine learning: random forest, Naive Bayes, decision tree, logistic regression and support vector machine;14 074 data (2 143 cases incase group and 11 931 cases in control group) were used to establish the early predication model of brucellosis, and 1 564 (238 cases in case group and 1 326 cases in control group) data were used to test the predication efficiency of the brucellosis model. The results showed that the support vector machine algorithm has the best predication performance by comparing the five machine learning models. The area under receiver curve (AUC) of receiver operating characteristic (ROC) was 0.991, and the accuracy, precision, specificity and Recall were 95.6%, 95.5%, 95.4% and 95.9%, respectively. Based on the SHAP plot, platelet distribution width (PDW) and basophil relative value (BASO%) results were low, and men with high coefficient of variation (R-CV), erythrocyte hemoglobin concentration (MCHC), and platelet volume (MPV) were predicted to be at high risk of brucellosis. Platelet distribution width (PDW) contributed the most to the prediction model, followed by red blood cell distribution width coefficient of variation (R-CV). In conclusion, the establishment of a high-precision early predication method of brucellosis based on machine learning may be of great significance for the early detection and treatment of brucellosis patients.
Male ; Humans ; Retrospective Studies ; Case-Control Studies ; Bayes Theorem ; Algorithms ; Machine Learning

Using machine learning algorithms to construct an early prediction model of brucellosis to improve the diagnosis efficiency of Brucellosis. This study was a case-control study. 2 381 brucellosis patients from Beijing Ditan Hospital affiliated to Capital Medical University were retrospectively collected as case group, and healthy people from Beijing Chaoyang Hospital affiliated to Capital Medical University were collected as control group from May 9, 2011 to November 29, 2021. The relevant clinical information and full blood count results of 13 257 data were collected and five algorithms of machine learning were used to construct an early predication model of brucellosis by using machine learning: random forest, Naive Bayes, decision tree, logistic regression and support vector machine;14 074 data (2 143 cases incase group and 11 931 cases in control group) were used to establish the early predication model of brucellosis, and 1 564 (238 cases in case group and 1 326 cases in control group) data were used to test the predication efficiency of the brucellosis model. The results showed that the support vector machine algorithm has the best predication performance by comparing the five machine learning models. The area under receiver curve (AUC) of receiver operating characteristic (ROC) was 0.991, and the accuracy, precision, specificity and Recall were 95.6%, 95.5%, 95.4% and 95.9%, respectively. Based on the SHAP plot, platelet distribution width (PDW) and basophil relative value (BASO%) results were low, and men with high coefficient of variation (R-CV), erythrocyte hemoglobin concentration (MCHC), and platelet volume (MPV) were predicted to be at high risk of brucellosis. Platelet distribution width (PDW) contributed the most to the prediction model, followed by red blood cell distribution width coefficient of variation (R-CV). In conclusion, the establishment of a high-precision early predication method of brucellosis based on machine learning may be of great significance for the early detection and treatment of brucellosis patients.
Male ; Humans ; Retrospective Studies ; Case-Control Studies ; Bayes Theorem ; Algorithms ; Machine Learning

Objective: To investigate the epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021, so as to provide insights into the prevention and control of overseas imported arthropod-borne infectious diseases. Methods: The data pertaining to imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 were collected from the Chinese Disease Prevention and Control Information System, and the temporal distribution, regional distribution, population distribution, sources, diagnosis and treatment of imported dengue fever and malaria cases were descriptively analyzed. Results: Totally 4 332 overseas imported dengue fever cases and 2 011 overseas imported malaria cases were reported in Yunnan Province form 2015 to 2021, which accounted for 30.09% of all reported dengue fever cases and 98.53% of all reported malaria cases. The number of overseas imported dengue fever and malaria cases peaked from August to November (83.13% of all imported dengue fever cases) and from April to July (59.08% of all imported malaria cases), and the cases were predominantly reported in Dehong Prefecture (50.99% and 58.88%), with farmers as the predominant occupation (40.21% and 67.93%). The dengue fever and malaria cases were mainly imported from Southeast Asia (99.04% and 88.21%), and the proportions of definitive diagnosis of dengue fever and malaria were 88.33% and 97.80% at township hospitals, respectively. Conclusions The number of overseas imported dengue fever and malaria cases peaked from August to November and from April to July in Yunnan Province from 2015 to 2021, and the cases were predominantly reported in Dehong Prefecture and imported from Southeast Asia, with farmers as the predominant occupation.

Bronchopulmonary dysplasia(BPD)is the main cause of chronic respiratory diseases in preterm infants.The research on the prophylaxis and treatment of BPD has been a concern of neonatologists because of its high incidence and poor prognosis in preterm infants.Glucocorticoid is a major therapy in the treatment of BPD because the pathological changes of BPD are characterized by persistent lung inflammation.Until now, a large number of clinical studies including different types and administration methods of glucocorticoids have been conducted.Compared with other types of glucocorticoids, low-dose and short-course dexamethasone has its unique advantages in the treatment of BPD.This article reviews the role of inflammation in the pathogenesis of BPD and the research progress of glucocorticoids in the prophylaxis and treatment of BPD.