This report described a case of hereditary thrombotic thrombocytopenic purpura (TTP) with neonatal onset. The infant presented with facial petechiae, jaundice, progressive thrombocytopenia, and persistent bleeding at puncture sites shortly after birth. Plasma ADAMTS13 activity was<1%. Whole-exome sequencing identified heterozygous variants in ADAMTS13: c.3121C>T and c.1869delT, inherited from the father and mother, respectively. The infant improved following exchange transfusion and phototherapy. Post-discharge, prophylactic fresh frozen plasma infusion was administered every 3-4 weeks. At the 2-year follow-up, no abnormalities were observed. This case highlights the importance of early recognition and intervention in neonates with unexplained thrombocytopenia, severe non-hemolytic jaundice, and anemia to ensure survival and improve prognosis.

Objective:To investigate the related factors of cognitive impairment in middle-aged and old-aged patients with type 2 diabetes mellitus(T2DM).Methods:A total of 970 patients with T2DM(585 middle-aged group and 385 old-aged group)were selected from residents of a large community in Beijing from September to December 2018.The Mini-Mental State Examination(MMSE)was used to assess the cognitive func-tion.Multivariate logistic regression was used to analyze the related factors.Results:The detection rates of cognitive impairment were 12.0％and 13.5％in middle-aged and old-aged patients with T2DM,respectively.Among mid-dle-aged patients with T2DM,work(OR=0.22,95％CI:0.03-0.77)and education at the junior college or un-dergraduate level and above(OR=0.18,95％CI:0.04-0.55)were protective factors for cognitive impair-ment.Myocardial infarction(OR=4.13,95％CI:1.26-13.63)was a risk factor for cognitive impairment.Among old-aged patients with T2DM,drinking tea 1-2 times a week(OR=0.11,95％CI:0.01-0.58)and education at the junior college or undergraduate level and above(OR=0.19,95％CI:0.05-0.54)were protective factors for cognitive impairment.Stroke(OR=3.64,95％CI:1.55-8.39)and good sleep self-assessment(OR=2.75,95％CI:1.13-7.35)were risk factors for cognitive impairment.Conclusion:Cognitive impairment in middle-aged pa-tients with T2DM is related to work,education level and myocardial infarction,and cognitive impairment in old-aged patients with T2DM is related to lifestyle,education level and stroke.

Objective:To investigate the related factors of cognitive impairment in middle-aged and old-aged patients with type 2 diabetes mellitus(T2DM).Methods:A total of 970 patients with T2DM(585 middle-aged group and 385 old-aged group)were selected from residents of a large community in Beijing from September to December 2018.The Mini-Mental State Examination(MMSE)was used to assess the cognitive func-tion.Multivariate logistic regression was used to analyze the related factors.Results:The detection rates of cognitive impairment were 12.0％and 13.5％in middle-aged and old-aged patients with T2DM,respectively.Among mid-dle-aged patients with T2DM,work(OR=0.22,95％CI:0.03-0.77)and education at the junior college or un-dergraduate level and above(OR=0.18,95％CI:0.04-0.55)were protective factors for cognitive impair-ment.Myocardial infarction(OR=4.13,95％CI:1.26-13.63)was a risk factor for cognitive impairment.Among old-aged patients with T2DM,drinking tea 1-2 times a week(OR=0.11,95％CI:0.01-0.58)and education at the junior college or undergraduate level and above(OR=0.19,95％CI:0.05-0.54)were protective factors for cognitive impairment.Stroke(OR=3.64,95％CI:1.55-8.39)and good sleep self-assessment(OR=2.75,95％CI:1.13-7.35)were risk factors for cognitive impairment.Conclusion:Cognitive impairment in middle-aged pa-tients with T2DM is related to work,education level and myocardial infarction,and cognitive impairment in old-aged patients with T2DM is related to lifestyle,education level and stroke.

This report described a case of hereditary thrombotic thrombocytopenic purpura (TTP) with neonatal onset. The infant presented with facial petechiae, jaundice, progressive thrombocytopenia, and persistent bleeding at puncture sites shortly after birth. Plasma ADAMTS13 activity was<1%. Whole-exome sequencing identified heterozygous variants in ADAMTS13: c.3121C>T and c.1869delT, inherited from the father and mother, respectively. The infant improved following exchange transfusion and phototherapy. Post-discharge, prophylactic fresh frozen plasma infusion was administered every 3-4 weeks. At the 2-year follow-up, no abnormalities were observed. This case highlights the importance of early recognition and intervention in neonates with unexplained thrombocytopenia, severe non-hemolytic jaundice, and anemia to ensure survival and improve prognosis.

Objective:To analyze the accuracy of lung ultrasound and chest X-ray in the diagnosis of neonatal pulmonary disease.Methods:We prospectively collected newborns that needed chest X-ray examination to diagnose pulmonary disease from twelve neonatal intensive care units across the country between June 2019 and April 2020.Each newborn was examined by lung ultrasound within two hours after chest X-ray examination.All chest X-ray and lung ultrasound images were independently read by a radiologist and a sonographer.When there was a disagreement, a panel of two experienced physicians made a final diagnosis based on the clinical history, chest X-ray and lung ultrasound images.Results:A total of 1 100 newborns were enrolled in our study.The diagnostic agreement between chest X-ray and lung ultrasound(Cohen′s kappa coefficient=0.347) was fair.Lung ultrasound(area under the curve=0.778; 95% CI 0.753-0.803) performed significantly better than chest X-ray(area under the curve=0.513; 95% CI 0.483-0.543) in the diagnosis of transient tachypnea of the newborn( P<0.001). The accuracy of lung ultrasound in diagnosing neonatal respiratory distress syndrome, meconium aspiration syndrome, pneumonia and neonatal pulmonary atelectasis was similar to that of chest X-ray. Conclusion:Lung ultrasound, as a low-cost, simple and radiation-free auxiliary examination method, has a diagnostic accuracy close to or even better than that of chest X-ray, which may replace chest X-ray in the diagnosis of some neonatal lung diseases.It should be noted that both chest X-ray and lung ultrasound can only be used as auxiliary means for the diagnosis of lung diseases, and it is necessary to combine imaging with the clinical history and presentation.

Objective:To investigate the stability of fat emulsions after the preparation of parenteral nutrient solution under different storage conditions.Methods:Standardized parenteral nutrient solution was used to prepare a total of 24 bags of nutrient solution with the same formula, except for that Group A (12 bags) contains 20% of medium and long chain fat emulsion (C6-24) while Group B contains 20% of C8-24. The preparations were stored under 2-8℃, 23-25℃, and 35-37℃ and were examined at 24h, 48h and 72h after preparation. The appearance, average size of fat particles, pH value of nutrient solution, and lipid peroxidation were investigated.Results:After storage at 4℃, 25℃ and 36℃ for 24h, 48h and 72h respectively, both groups of preparations showed no obvious change in appearance. There was no significant difference in pH ( P>0.05) nor lipid peroxidation ( P>0.05). Conclusion:Both kinds of fat emulsion are stable in terms of pH value, fat particle size and lipid peroxidation, and can be used for patients receiving intravenous nutrition support.

Objective: To investigate the sonographic features of appendicitis in preterm infants. Methods: A total of 28 cases of premature infants with acute appendicitis diagnosed by bedside abdominal ultrasound in the First Hospital of Jilin University from November 2012 to January 2019 were recruited. Basic clinical information, abdominal ultrasound images, surgical results, management and outcomes were collected and analyzed. Descriptive statistical methods were used for data analysis. Results: Among the 28 cases, 21 (75.0%) were males and seven (25.0%) were females. All of them were diagnosed as having acute appendicitis with perforation according to the bedside ultrasound. Five (17.8%) presented direct signs of appendicitis, i.e. partial structure of the appendix and perforation site. The other 23 (82.2%) showed indirect signs, including heterogeneous echotexture or hypoechoic patterns between the liver and right kidney in six cases, heterogeneously hypoechoic areas between the bowels in the right lower abdomen in seven cases, and dissociative effusion between the bowels in the right lower abdomen with poor sound transmission and disorder of surrounding intestinal structure in ten cases. Twenty-one out of the 28 cases (75.0%) exhibited bowel wall thickening at right lower abdomen, absence of intestinal peristalsis and effusion echoes between the intestines with poor sound transmission. Emergent surgeries were performed and diagnoses of appendicitis with perforation were confirmed. All the 21 cases were discharged after full recovery. Seven cases (25.0%) showed confined cystic images and received conservative treatment. One of them developed adhesive intestinal obstruction during follow-ups and underwent surgical treatment, during which local formations of wrapping after appendiceal perforation and obstruction due to surrounding intestinal adhesion were observed. The other six cases recovered after conservative management with gradually reduced peritoneal effusion, normal omental echo patterns and improved inflammatory indicators and abdominal symptoms, and no ileus occurred during follow-ups after discharge. Conclusions Symptoms of appendicitis in preterm infants are non-specific, and perforation is more likely to be seen. Bedside ultrasonography mainly shows indirect signs of appendicitis, and direct signs in some infants. Bedside ultrasound can be an essential tool for the diagnosis of these conditions with high accuracy.

Nafamostat mesilate (NM), a synthetic serine protease inhibitor, has anticoagulant and anti-inflammatory properties. The intracellular mediator and external anti-inflammatory external signal in the vascular wall have been reported to protect endothelial cells, in part due to nitric oxide (NO) production. This study was designed to examine whether NM exhibit endothelium dependent vascular relaxation through Akt/endothelial nitric oxide synthase (eNOS) activation and generation of NO. NM enhanced Akt/eNOS phosphorylation and NO production in a dose- and time-dependent manner in human umbilical vein endothelial cells (HUVECs) and aorta tissues obtained from rats treated with various concentrations of NM. NM concomitantly decreased arginase activity, which could increase the available arginine substrate for NO production. Moreover, we investigated whether NM increased NO bioavailability and decreased aortic relaxation response to an eNOS inhibitor in the aorta. These results suggest that NM increases NO generation via the Akt/eNOS signaling pathway, leading to endothelium-dependent vascular relaxation. Therefore, the vasorelaxing action of NM may contribute to the regulation of cardiovascular function.
Animals ; Aorta ; Arginase ; Arginine ; Biological Availability ; Endothelial Cells ; Endothelium ; Human Umbilical Vein Endothelial Cells ; Mesylates* ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type III ; Phosphorylation ; Rats ; Relaxation ; Serine Proteases ; Vasodilation*

Objective To compare the fluorescence intensity and duration of qdots streptavidin conjugate (QDs-SA) with Cy3 as the molecular probe of β amyloid precursor protein (APP), and to provide evidence for early molecular imaging and diagnosis of Alzheimer's dissease (AD). Methods With the help of laser scanning confocal microscope and flow cytometry, the flurescence probe based on the QDs-SA was used to detect APP in HEK293 cells stably transfected pcDNA3.1/APP, and to compare with conventional fluroimmunoassay Cy3. Results The immunofluorescence staining detection indicated APP expression was mainly located in the plasma membrane. The mean fluorescence intensity of QDs-SA (34.2336±4.2455) was greater than that of Cy3 (21.6023±3.0102)under the confocal fluorescence microscope (P<0.05). After persistent exciting for 12 min, the fluorescence intensity of APP stained by QDs-SA decreased by 27.87%. The other stained by Cy3 decreased by 79.60%. The positive rate of APP staining had no significant difference between the QDs-SA(54.4700±3.4433)% and Cy3 (54.3800±8.5229)% by flow cytometry, but the mean fluorescence intensity had statistical significance(P<0.05). The QDs-SA (1 045.4167±47.3623) was significantly higher than the mean fluorescence intensity of Cy3 (658.5467±55.0591). Conclusion QDs-SA fluorescence probes can effectively recognize APP and are sensitive and exceptionally photostable, suggesting that QDs-SA fluorescence probes could be a potential method in APP detection and offer a novel way for the diagnosis of Alzheimer's disease.

BACKGROUND:High pulse pressure is the signal of arteriosclerosis or cardiovascular diseases for both hypertension and normal blood pressure population.OBJECTIVE:The pulse pressure and related factors of healthy adults in Sichuan province were analyzed to explore the method for preventing excessive pulse pressure and improving the quailty of life.METHODS:Hierarchical,cluster sampling were performed in 1989 healthy adults.The physical examination,blood glucose,renal function and blood fat were detected,and the relation of pulse pressure and its related factors were analyzed.RESULTS AND CONCLUSION:Pulse pressure increased following the age.especially showed a linear increasing in those who more than 50-year-old The increased pulse pressure leaded to larger fasting plasma glucose,uric acid,blood urea nitrogen,total cholesterol,triacylglycerol,systolic pressure and diastolic pressure,in addition,the age,body mass index,waist-to-hip ratio,triacylglycerol and pulse pressure showed a linear relationship.But physical exercise was negative correlated to pulse pressure.With pulse pressure increasing,the renal function and regulating capacity of blood glucose was decreased The results suggested that mid-aged population should take reasonable diet and more physical exercise to prevent central obesity and excessive pulse pressure,reduce the risk of renal dysfunction and the incidence of cardiovascular disease.