Bacterial infection is a major threat to global public health, and can cause serious diseases such as bacterial skin infection and foodborne diseases. It is essential to develop a new method to rapidly diagnose clinical multiple bacterial infections and monitor food microbial contamination in production sites in real-time. In this work, we developed a 4-mercaptophenylboronic acid gold nanoparticles (4-MPBA-AuNPs)-functionalized hydrogel microneedle (MPBA-H-MN) for bacteria detection in skin interstitial fluid. MPBA-H-MN could conveniently capture and enrich a variety of bacteria within 5 min. Surface enhanced Raman spectroscopy (SERS) detection was then performed and combined with machine learning technology to distinguish and identify a variety of bacteria. Overall, the capture efficiency of this method exceeded 50%. In the concentration range of 1 × 10⁷ to 1 × 10¹⁰ colony-forming units/mL (CFU/mL), the corresponding SERS intensity showed a certain linear relationship with the bacterial concentration. Using random forest (RF)-based machine learning, bacteria were effectively distinguished with an accuracy of 97.87%. In addition, the harmless disposal of used MNs by photothermal ablation was convenient, environmentally friendly, and inexpensive. This technique provided a potential method for rapid and real-time diagnosis of multiple clinical bacterial infections and for monitoring microbial contamination of food in production sites.

Bacterial infection is a major threat to global public health,and can cause serious diseases such as bacterial skin infection and foodborne diseases.It is essential to develop a new method to rapidly di-agnose clinical multiple bacterial infections and monitor food microbial contamination in production sites in real-time.In this work,we developed a 4-mercaptophenylboronic acid gold nanoparticles(4-MPBA-AuNPs)-functionalized hydrogel microneedle(MPBA-H-MN)for bacteria detection in skin inter-stitial fluid.MPBA-H-MN could conveniently capture and enrich a variety of bacteria within 5 min.Surface enhanced Raman spectroscopy(SERS)detection was then performed and combined with ma-chine learning technology to distinguish and identify a variety of bacteria.Overall,the capture efficiency of this method exceeded 50％.In the concentration range of 1 × 10 7 to 1 × 10 10 colony-forming units/mL(CFU/mL),the corresponding SERS intensity showed a certain linear relationship with the bacterial concentration.Using random forest(RF)-based machine learning,bacteria were effectively distinguished with an accuracy of 97.87％.In addition,the harmless disposal of used MNs by photothermal ablation was convenient,environmentally friendly,and inexpensive.This technique provided a potential method for rapid and real-time diagnosis of multiple clinical bacterial infections and for monitoring microbial contamination of food in production sites.

Objective To analyze the influence of medication compliance of chronic type 2 diabetes management patients on disease control in two communities in Kunming.Methods A total of 138 patients with type 2 diabetes who were included in chronic disease management in Guandu and Xiaobanqiao communities of Kunming were selected from December 2021 to September 2022.Basic information collection and HbAlc and other related tests were improved.A questionnaire survey of 8-item Morisliy medication adherence scale(MMAS-8)was conducted to analyze the levels of HbAlc and other indexes of three groups with high(group A),medium(group B),and low(group C)adherence,and to conduct statistical analysis.Results Group A accounted for 22.5%,group B for 44.9%,and group C for 32.6%.There were significance differences in urinary albumin creatinine ratio(UACR),HbA1c and blood creatinine among the three groups(P<0.05).The levels of UACR,HbAlc and serum creatinine in group A were lower than those in group B and group C,and there was a negative correlation between UACR,HbAlc and serum creatinine and medication compliance rate(P<0.05).Conclusion In the Guandu Community and Xiaobanqiao community of Kunming,only 22.5%of patients with chronic type 2 diabetes had high medication compliance.The higher the compliance,the lower the level of UACR,HbAlc and serum creatinine,there is a correlation between the two,suggesting that medication compliance should be regarded as one of the key points in the management of chronic diabetes mellitus in the community,and the intervention of patients'medication compliance should be strengthened.

Purpose To explore the feasibility of prenatal MRI as a supplementary imaging examination of fetal multicystic dysplastic kidney(MCDK),and to improve the accuracy of imaging diagnosis.Materials and Methods The MR images of 104 fetuses diagnosed as MCDK by prenatal fetal MRI in Hubei Maternal and Children's Hospital from January 2018 to December 2021 were retrospectively analyzed.The results of fetal MRI were compared with those of autopsy or postnatal surgery,ultrasound and MRI,and the diagnostic accuracy of MRI and ultrasound was compared,respectively,the advantages of MRI combined with ultrasound in the diagnosis of MCDK was also analyzed.Results Among 104 fetuses diagnosed as MCDK by MRI,there were 102 cases with MCDK and 2 cases with misdiagnoses.Amniotic fluid was obviously reduced or absent in 4 cases.Among the 102 cases of MCDK,58 cases(56.9％)were correctly diagnosed as MCDK by ultrasound,40 cases(39.1％)were identified with polycystic alterations,without diagnosed as MCDK,and 4 cases(3.9％)were misdiagnosed as other diseases(1 case with adult polycystic kidney,1 case with multiple renal cyst and 2 cases with renal absence).Conclusion Compared with prenatal ultrasound,prenatal MRI can obtain more information,especially in oligohydramnios and maternal obesity affecting the quality of ultrasound image.MRI can be used as a reliable supplementary method of prenatal ultrasound.

Objective:To retrospectively analyze the classification of twin reversed arterial perfusion(TRAP) by prenatal ultrasound diagnosis, and to explore the clinical significance of this classification method.Methods:One hundred and fourteen TRAP cases were selected for prenatal ultrasound examination from January 2001 to January 2020 in Maternal and Child Health Hospital of Hubei Province, and were studied following the classification: hemiacardius(type Ⅰ), anceps trunk(type Ⅱ), acephalus trunk(type Ⅲ), acephalus acormus(type Ⅳ), acardius amorphous(type Ⅴ). Natural pregnancy outcomes were analyzed between group A(type Ⅰ, type Ⅱ, type Ⅲ) and group B(type Ⅳ, type Ⅴ).Results:Among 114 cases of TRAP, 27 cases (23.7%) were live birth, 33 cases (29.0%) were intrauterine death, 7 cases (6.1%) were perinatal death, 22 cases (19.3%) were induced labor complicated with heart failure, 4 cases (3.5%) were induced labor with malformation of pump twin, 21 cases (18.4%) were induced without heart failure of pump twim. Among 114 cases of TRAP, 20 cases (17.5%) were type Ⅰ, 27 cases (23.7%) were type Ⅱ, 48 cases (42.1%) were type Ⅲ, 8 cases (7.0%) were type Ⅳ and 11 cases (9.7%) were type Ⅴ. The prognosis of group B was better than group A during natural pregnancy ( P=0.007). Conclusions:Based on the diagnosis of prenatal ultrasound, the prognosis of type Ⅳ and type Ⅴ TRAP is better than that of type Ⅰ, type Ⅱ and type Ⅲ. The classification by prenatal ultrasound has positive significance for the clinical prognosis of pump twin.

Thyroid diseases in fetuses and newborns are rare but can be severe in some cases. Early diagnosis and treatment are the keys to improve the prognosis. This review focuses on the diagnosis and treatment strategies of this disease during the fetal and neonatal periods. For fetuses with goiter, the main clinical issue is to differentiate hyperthyroidism or hypothyroidism and offer appropriate management on this basis. Management of maternal, fetal, and neonatal thyroid diseases requires an experienced multidisciplinary team including adult and pediatric endocrinologists, obstetricians, and sonographers.

BACKGROUND: Many studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between cobalt exposure and CHD occurrence in offspring. The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring. MATERIALS AND METHODS: In order to explore the association between cobalt exposure and occurrence of congenital heart defect (CHD), a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of cobalt in hair of pregnant woman and fetal placental tissue were measured and processed by a logistic regression analysis to explore the relationship between cobalt exposure and risk of CHDs. RESULTS: The median concentration of hair cobalt in the control and case group was 0.023 ng/mg and 0.033 ng/mg (aOR, 1.837; 95% CI, 1.468-2.299; P < 0.001), respectively. And the median (5-95% range) fetal placental cobalt concentrations were 19.350 ng/g and 42.500 ng/g (aOR, 2.924; 95% CI, 2.211-3.868; P < 0.001) in the control and case groups, respectively. Significant differences in the middle level of cobalt in hair were found in the different CHD subtypes, including septal defects, conotruncal defects, right ventricular outflow tract obstruction, and left ventricular outflow tract obstruction (P < 0.001). Dramatically, different cobalt concentrations in fetal placental tissue were found in all subtypes of cases with CHDs (P < 0.01). CONCLUSIONS The finding suggested that the occurrence of CHDs may be associated with cobalt exposure.
Adolescent ; Adult ; Case-Control Studies ; China ; Cobalt ; adverse effects ; Female ; Hair ; chemistry ; Heart Defects, Congenital ; chemically induced ; Humans ; Maternal Exposure ; adverse effects ; Placenta ; chemistry ; Pregnancy ; Prenatal Exposure Delayed Effects ; chemically induced ; Risk Factors ; Young Adult

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.

Objective To investigate the value of clinical follow-up in prenatal diagnosis of isolated double aortic arch (DAA) . Methods The clinical follow-up materials were retrospectively reviewed in 17 fetuses . Of all the isolated DAA fetuses ,the accuracy rate of prenatal diagnosis was confirmed by CT ,MRI , autopsy or echocardiography ,and pregnant outcomes were summarized . Results A total of 17 fetuses had a sonographic diagnosis of isolated DAA in our centers at a mean gestational age of 23 -32(27 ± 3) weeks , with mother mean age 19 -44 (28 ± 6) years old . One case of DAA type-A was misdiagnosed ,15 cases were delivered with 2 cases occurred respiratory distress or mild dysphagia ,who received surgical treatment , and 13 cases clinical findings were unremarkable at the fellow-up of 24 months ,the silent-rate of clinical symptoms was 86％ . Termination of pregnancy happened in 2 cases ,with 1 (6％ ) had additional ventricular septal defects ,another ( 6％ ) had additional anomalies of congenital high airway obstruction syndrome . In 17 cases of fetuses with isolated DAA ,there were 15 ( 88％ ) cases with dominant right-sided arch ,1 case (6％ ) with dominant left arch ,and 1 case (6％ ) with equal arches in size .Karyotyping prenatal testing was offered to 15 parents with normal results . Conclusions Prenatal ultrasound can accurately diagnose isolated DAA by multiple sections scan ,expanding diagnostic ideas by combination with other medical imaging data to prevent apparent life-threatening event ,or to guide for ex-utero intrapartum treatment . Isolated DAA clinical follow-up results in good outcome .

Objective To explore the value of prenatal ultrasound in diagnosis of omphalocele-exstrophy-imperforate anusspinal defects (OEIS) in first trimester.Methods Prenatal ultrasonic characteristics of 10 fetuses with OEIS complex in first trimester were retrospectively analyzed and compared with autopsy results.Results Cystic bulging in the lower anterior abdominal wall was observed in all 10 fetuses.Spinal scoliosis dysplasia was found in 10 fetuses,with myelomeningocele in 3 fetuses.No normal bladder was visualized in 8 fetuses.Thickened nuchal translucency was noticed in 5 fetuses,among which neck lymphatic hydrocele was found in 1 fetus.The bilateral clubbed feet and left lower mutilation was observed in 1 fetus,respectively.All 10 OEIS complex fetuses were found accompanied with short umbilical cord,while single umbilical artery and umbilical cord cyst were found in 4 and 1 fetus,respectively.Autopsy showed abdominal wall defects with exstrophy in 10 fetuses.However,no complete cystic bulging was found.Besides,autopsy also showed pubic symphysis separation and bladder exstrophy in 10 fetuses without obvious genitalia nor anus.Conclusion Cystic bulging in the lower anterior abdominal wall is the most common prenatal ultrasonic characteristic of OEIS complex in first trimester.