Objective:To review the clinical characteristics, treatment and prognosis of patients with Klebsiella pneumoniae endogenous endophthalmitis in the past 20 years, in order to guide diagnosis and treatment.Methods:Patients with Klebsiella pneumoniae endogenous endophthalmitis who visited the Ophthalmology Department of Peking Union Medical College Hospital from January 2004 to December 2023 were retrospectively included. The basic information, general condition, microbiological evidence, treatment regimens and prognosis of the patients were statistically analyzed.Results:A total of 26 patients (33 affected eyes) were included, with an age of (53.6±12.6)years. Among them, 76.9%(20/26) of the patients had diabetes mellitus, 61.5%(16/26) of the patients had liver abscess, and 88.5%(23/26) of the patients visited the hospital due to systemic infection symptoms such as fever rather than ocular symptoms. Thirty affected eyes underwent complete ocular sign examinations. The time from the appearance of ocular symptoms to the first ophthalmic visit of the patients was (10.5±6.2)days. The best corrected visual acuity of the minimum resolution visual Angle logarithm (logMAR) of the affected eyes at the visit was (2.3±0.9), and retinal detachment occurred in 70.0%(21/30) of the affected eyes. Thirty-three affected eyes received (2.9±2.3) intravitreal antibiotic injections. 66.7%(22/33) of the affected eyes underwent vitreous surgeries, and 24.2%(8/33) of the affected eyes eventually underwent enucleation of the ocular contents or enucleation of the eyeball. The median follow-up time for the patients was 111 days. The logMAR best corrected visual acuity at the last follow-up was (2.1±0.9), and only 27.3%(9/33) of the affected eyes had improved visual acuity compared with that at the first visit.Conclusions:Klebsiella pneumoniae endogenous endophthalmitis progresses rapidly and has a poor prognosis. The combined systemic and intraocular application of antibiotics and vitreous surgeries are crucial for eye protection. Early diagnosis and early treatment are the most crucial.

Objective:To review the clinical characteristics, treatment and prognosis of patients with Klebsiella pneumoniae endogenous endophthalmitis in the past 20 years, in order to guide diagnosis and treatment.Methods:Patients with Klebsiella pneumoniae endogenous endophthalmitis who visited the Ophthalmology Department of Peking Union Medical College Hospital from January 2004 to December 2023 were retrospectively included. The basic information, general condition, microbiological evidence, treatment regimens and prognosis of the patients were statistically analyzed.Results:A total of 26 patients (33 affected eyes) were included, with an age of (53.6±12.6)years. Among them, 76.9%(20/26) of the patients had diabetes mellitus, 61.5%(16/26) of the patients had liver abscess, and 88.5%(23/26) of the patients visited the hospital due to systemic infection symptoms such as fever rather than ocular symptoms. Thirty affected eyes underwent complete ocular sign examinations. The time from the appearance of ocular symptoms to the first ophthalmic visit of the patients was (10.5±6.2)days. The best corrected visual acuity of the minimum resolution visual Angle logarithm (logMAR) of the affected eyes at the visit was (2.3±0.9), and retinal detachment occurred in 70.0%(21/30) of the affected eyes. Thirty-three affected eyes received (2.9±2.3) intravitreal antibiotic injections. 66.7%(22/33) of the affected eyes underwent vitreous surgeries, and 24.2%(8/33) of the affected eyes eventually underwent enucleation of the ocular contents or enucleation of the eyeball. The median follow-up time for the patients was 111 days. The logMAR best corrected visual acuity at the last follow-up was (2.1±0.9), and only 27.3%(9/33) of the affected eyes had improved visual acuity compared with that at the first visit.Conclusions:Klebsiella pneumoniae endogenous endophthalmitis progresses rapidly and has a poor prognosis. The combined systemic and intraocular application of antibiotics and vitreous surgeries are crucial for eye protection. Early diagnosis and early treatment are the most crucial.

Objective:To investigate the association between peripheral immune function status and lung cancer metastasis,and to identify peripheral blood immune biomarkers for'Deficiency of Vital Qi'assessment in lung cancer metastasis.Methods:A retrospective analysis was conducted on peripheral blood immune markers collected before treatment from lung cancer patients admitted into Shanghai Municipal Hospital of Traditional Chinese Medicine,affiliated to Shanghai University of Traditional Chinese Medicine,between March 2023 and April 2025.Patients were categorized into the non-metastatic and the metastatic groups based on the presence of distant metastasis,and the differences in the expressions of immune cells and cytokines between groups were compared.Peripheral blood immune markers with P<0.05 in univariate analysis were incorporated into a multivariate binary logistic regression model to identify independent predictors of lung cancer metastasis.Results:A total of 193 lung cancer patients were included(101 in the non-metastatic group and 92 in the metastatic group).There were no statistically significant differences between the two groups in terms of gender,age,smoking history,drinking history,or pathological type(all P>0.05).Univariate analysis revealed significant differences in multiple immune markers between the non-metastatic and metastatic groups(all P<0.05),including:lymphocyte count,CD3+,CD4+,and CD8+T,CD19+B cells,absolute counts of CD3-CD16+CD56+NK cells,percentages of Treg cells,CD8+CD28+Treg cells,G-MDSC,and CD3-CD16+CD56+dim NK cells,and levels of cytokine IL-1β,IL-6,and IL-10.Binary logistic regression analysis of differential indicators suggested that the percentage of Treg cells and CD8+CD28+Treg cells in peripheral blood were independent predictors of distant metastasis in lung cancer(OR=1.193,95%CI[1.047,1.36],P<0.01;OR=0.978,95%CI[0.957,0.999],P<0.05).Conclusion:Peripheral blood immune dysfunction is the biological basis for'qi deficiency'in lung cancer metastasis.This study quantitatively demonstrates the correlation between peripheral immune function status and lung cancer metastasis,providing empirical evidence for the theories of'qi deficiency and hidden toxicity'and'metastatic state of tumors'.

Objective To investigate the clinical application of perioperative human serum albumin(HSA)in cardiac surgery in multiple regions in China,and to evaluate the rationality of its clinical application in conjunction with the clinical guidelines,in order to provide a reference for promoting the rational application of HSA.Methods The medical records of patients who underwent cardiac surgery from April to June 2019 in eight hospitals across the country were retrospectively collected.The statistical information on patients'general information,the dosage,course of treatment,and cost of HSA,and the serum albumin level before and after medication was analyzed to evaluate the use of HSA.Relevant evaluation criteria were established,and the rationality of its medication was evaluated.Results Data from a total of 449 patients were included for analysis,the appropriate rate of medication was 81.1％.The course of medication was mostly＞2-5 days and the total amount of HSA was mostly 50-99 g.The main purpose of medicaiton were improving colloid osmotic pressure,reducing exudation to improve interstitial edema,postoperative volume expansion.Conclusion Clinical attention should be paid to ensure the rational application of HSA in cardiac surgery during the perioperative period and prevent the abuse of blood products.

Objective To investigate the changes of hypoxia-inducible factor (HIF-1α, HIF-2α) expression level in lung cancer A-549 cells under normoxic conditions, different hypoxia durations, and different oxygen concentrations. Methods A549 cells were divided into normoxic group, time control group, and oxygen concentration control group. Western blot was used to detect the expression of HIF-1α and HIF-2α in A-549 cells.Results The expression of HIF-1α and HIF-2α protein were lower under normoxia and significantly increased under hypoxic conditions. The difference was statistically significant. The lower the oxygen concentration, the more HIF-1α and HIF-2α protein expression levels were. The differences between high and high were statistically significant. The expression of HIF-1α protein increased at 2 h after hypoxia, peaked at 8 h, appeared plateau at 8 to 16 h, and decreased at 32 h, with a statistically significant difference. HIF-2α proteins gradually increased with prolonged hypoxia. Conclusions Under hypoxic conditions, the expression of HIF-1α and HIF-2α are increased, and the expression of HIF-2α has a time-dependent pattern, which may have more important biological significance.

Objective To analyze and compare the postoperative complications and perioperative data of laparotomy surgery and combined laparoscopy and choledochoscopy surgery for non-severe acute cholangitis.Methods Retrospective analyzed the clinical data of 134 patients,with non-severe acute cholangitis at First Affiliated Hospital of He'nan University from June 2015 to May 2017.The patients were divided into combined group (76 cases) and traditional group (58 cases) according to operation mode,and the postoperative complications and perioperative data including amount of bleeding,postoperative exhaust time,operative time,incision length,length of stay and extubation time of T-tube were compared.The measurement data were expressed by (-x ± s),and the t test was used between the groups.Comparison of count data were analyzed using the chi-square test.Results The amount of bleeding,postoperative exhaust time,incision length and length of stay were respectively (48.90 ± 16.23) ml,(1.94 ± 0.45) d,(4.53 ±1.97) cm,(7.81 ±2.23) d in the combined group and were significantly less than those in the traditional group (98.53 ± 17.34) ml,(2.42 ± 0.56) d,(8.34 ± 2.05) cm,(12.27 ± 1.56) d,with statistically significant diffbrences between the two groups (t =7.173,8.242,12.847,8.242;P =0.000,0.000,0.004,0.021).The operative time of the combined group was (157.75 ± 17.34) min,and that of the traditional group was (138.43 ±23.84) min,but there was no significant difference between the two groups (t =13.661,P =0.069).The extubation time of T-tube in the combined group and the traditional group was (29.78 ± 1.54) d and (22.54 ± 0.96) d,respectively.The differences between the two groups were statistically significant (t =3.435,P =0.043).Postoperative complications occurred in 16 out of all 134 patients,and bile leakage,residual stones and incision infection were the top three complications.The incidence of postoperative complications in the combined group and the traditional group was 5.26％ (4/76)and 20.69％ (12/58),respectively.The differences between the two groups were statistically significant (x2 =7.445,P =0.006).Conclusion The incidence of complications of calculous non-severe acute cholangitis combined laparoscopy and choledochoscopy is lower than traditional surgical operations,and more conforms to the enhanced recovery after surgery,and the postoperative recovery is faster than that of the traditional group.

Recent studies have shown that changes in the form and color of sublingual collaterals were related to diabetes. And the changes of sublingual collaterals have certain clinical value in judging the condition, stage, treatment and prognosis of diabetes. This article summarized the research progress of sublingual collaterals from two aspects: the relationship between sublingual collaterals and diabetes mellitus and laboratory indexes, and the modern science and technology.

Objective To investigate the diagnosis and treatment of congenital mesenteric hiatal hernia in aduls.Methods The retrospective cross-sectional study was conducted.The clinical data of 11 adult patients with congenital mesenteric hiatal hernia who were admitted to the First Affiliated Hospital of Henan University from January 1999 to January 2016 were collected.All patients underwent abdominal X-ray and ultrasound examinations.Patients diagnosed as with intestinal obstruction or suspected intra-abdominal hernias underwent abdominal CT examination,and then were finally confirmed during surgery.Patients diagnosed as with mesenteric hiatal hernia received necrotic tissues resection and tissue repair (small intestine resection and anastomosis) if there was necrosis of hernia contents,and closing mesenteric hiatus.Patients without small intestine necrosis received closure of mesenteric hiatus after retraction of the hernia contents.Observation indicators:(1) clinical manifestations,(2) imaging findings,(3) treatment,(4) pathological examination,(5) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative complications up to March 2017.Results (1) Clinical manifestations:all 11 patients were acute onset,with incentives of satiation,postprandial exercise and diarrhea.The time from onset to admission was 2.0-30.0 hours,with an average time of 9.8 hours.The main symptoms included abdominal pain,nausea and vomiting,exhaust reduction and other intestinal obstruction performances.Eleven patients received physical examination,and 10 showed abdominal bulge,including 9 with intestinal type.Eleven patients had abdominal tenderness,and 9 combined with rebound tenderness.Abdominal percussion of 11 patients showed hyperresonant without shifting dullness,and active,muted and fading bowel sounds were detected in 1,3 and 7 patients,respectively.(2) Imaging examination:of 11 patients receiving abdominal X-ray examination,2 had intestinal loop and 4 had the intestinal obstruction performances such as typical gas-liquid plane.Abdominal ultrasound examination of 11 patients showed no specific findings due to abdominal intestinal gas,and 10 with peritoneal effusion.Of 11 patients,1 didn't receive abdominal CT scan due to preoperatively misdiagnose with acute appendicitis and 10 underwent abdominal CT scan.Nine patients were diagnosed with intestinal torsion by abdominal CT scan and then underwent enhanced CT scan,and 8 with small mesenteric vascular torsion and swirling sign were diagnosed with small intestine torsion and partial necrosis of small intestine.(3) Treatment:1 patient preoperatively misdiagnosed with acute appendicitis was converted to exploratory laparotomy,and 10 patients underwent exploratory laparotomy due to complete intestinal obstruction or progressive increase in symptoms.Intraoperative exploration showed that intestinal mesenteric hiatus and colon mesenteric hiatus were respectively in 8 and 3 patients,and hiatuses were round or oval,with a diameter of 2.0-8.0 cm and an average of 4.4 cm.Hernia contents were small intestine.The partial small intestine in 10 patients were resected and then mesenteric hiatus was closed due to necrosis of the small intestine,with removal length of 110-250 cm and an average of 176 cm,and length of remaining small intestine was 80-230 cm,with an average of 159 cm.The hernia into small intestine in 1 patient without complete necrosis was retracted to abdominal cavity after symptomatic treatment,and closing mesenteric hiatus.Eleven patients were cured and out of hospital after operation,without nosocomial complications.(4) Pathological examination:small intestine ischemic necrosis was detected in 10 patients after partial small intestine resection.(5) Follow-up situations:all patients were followed up for 12-24 months,without malnutrition,short bowel syndrome and other complications.Conclusions Without history of abdominal trauma or surgery,with incentives of the satiation,postprandial exercise and diarrhea,abnormal retroperitoneal small intestine shadow and small intestinal torsion diagnosed by CT scan and absent intestine sign by enhanced CT scan can be helpful to diagnose congenital mesenteric hiatal hernia in adults and small intestinal necrosis.Surgery is the only effective method in the treatment of congenital mesenteric hiatal hernia in adults.

Objective To study the diagnostic value of common inflammatory markers in patients with infectious diseases. Methods One hundred sepsis patients, 100 viral infection patients,100 pulmonary tuberculosis patients and 100 gonorrhea patients were analyzed retrospectively. The contents of procalcitonin (PCT), C-reactive protein (CRP), haptoglobin (HP), ceruloplasmin (CER), α1-acid glycoprotein (α1-AAG), α1-antitrypsin (α1-AAT), white blood cell count (WBC) and erythrocyte sedimetation rate (ESR) were measured. The receiver operating characteristic curve (ROC curve), sensitivity, specificity, positive predictive value, negative predictive value, Youden's index,positive and negative likelihood ratios and total coincidence rate were calculated respectively. Results The area under the ROC curve, sensitivity, specificity, Youden's index and positive likelihood ratios,positive predictive value and total coincidence rate of PCT in sepsis patients were 0. 895, 0.84, 0.92,0.76, 10.50, 0.91 and 0.88, respectively, which were superior to CRP, HP, CER, α1-AAG, α1-AAT, WBC and ESR. Conclusions PCT is a better inflammatory reactive parameter than other parameters currently applied in practice and may serve as a rapid and sensitive test in the early stage of severe bacterial infections.

OBJECTIVE: To analyse the clinical audiological significance in the diagnosis of large vestibular aqueduct syndrome (LVAS) by the auditory brain stem response (ABR) testing. METHOD: Patients with sensorineural hearing loss were examined by temporal bone CT scanning from January, 2008 to September, 2009. The result of CT scanning of 70 cases inner ear malformation were analysed. Patients were divided into two groups, LVAS group including 38 cases (76 ears) and other inner ear malformation group including 32 cases (62 ears). All patient accepted clinical audiology analysis and auditory brainstem response (ABR) test. RESULT: Twenty-four cases (41 ears) of LVAS group were detected with ASNR in 2 3 cm by the ABR testing, the positive rate was 54%, while ASNR was not detected in patients of other inner ear malformations group. There was significant differences (P=0.01) of the ASNR between two groups. CONCLUSION There is high incidence of LVAS on the patients with non-syndromic deafness. ASNR by ABR testing could help diagnosing the LVAS.
Child ; Child, Preschool ; Ear, Inner ; abnormalities ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss, Sensorineural ; diagnosis ; physiopathology ; Humans ; Infant ; Infant, Newborn ; Male ; Syndrome ; Vestibular Aqueduct ; abnormalities