Pneumocystis jirovecii pneumonia (PJP) is an opportunistic pulmonary infection that commonly occurs in immunocompromised children. We report a case of infantile leukemia complicated by PJP and review the relevant literature. A summary and analysis of 10 infantile leukemia patients with PJP infection (9 cases reported in the literature and 1 case from our center) showed that PJP mostly occurred in the early stages of chemotherapy (80%, 8/10). The main clinical manifestations were dyspnea (100%, 10/10) and hypoxemia (50%, 5/10), while pulmonary imaging findings lacked specificity. In most cases (50%, 5/10), diagnosis was established by identifying pathogens in bronchoalveolar lavage fluid under microscopy. In our case, diagnosis was confirmed using targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid. Treatment with intravenous sulfamethoxazole complex was administered in 8 patients, all of whom eventually recovered. PJP may occur in the early stages of chemotherapy for infantile leukemia, thus early prevention is necessary. tNGS facilitates early diagnosis of PJP, and sulfamethoxazole complex remains an effective therapeutic option.
Humans ; Infant ; Bronchoalveolar Lavage Fluid/microbiology* ; Immunocompromised Host ; Leukemia/complications* ; Pneumocystis carinii/isolation & purification* ; Pneumonia, Pneumocystis/diagnosis* ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use*

Objective To investigate the effects of probiotics combined with dietary intervention on pe-ripheral blood glucose and lipid metabolism indicators,placental tissue insulin signaling pathway proteins ex-pression and pregnant outcome in the patients with gestational diabetes mellitus(GDM).Methods A total of 83 patients with GDM in this hospital from December 2021 to December 2022 were selected as the study sub-jects and divided into the probiotics group(probiotics combined with diet intervention,43 cases)and control group(simple diet intervention,40 cases)by the random number table method.The levels of peripheral blood glucose,lipid and insulin resistance related indicators before the intervention and in 8 weeks after the interven-tion were compared between the two groups.The histological changes of placenta were observed by HE stai-ning.The pathological indicators were compared between the two groups.The expression levels of insulin re-ceptor substrate-1(IRS-1),glucose transporter 4(GLUT4)and synaptosome-associated protein of 23 kDa(SNAP23)in placental tissue were detected by immunohistochemistry.The pregnant adverse outcomes were compared between the two groups,and the clinical efficacy of probiotics was evaluated.Results Compared with the control group,the levels of fasting blood glucose(FBG),fasting insulin(FINS),serum triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in 8 weeks after intervention in the probiotics group were significantly decreased(P＜0.05),and the level of serum high density lipoprotein cholesterol(HDL-C)was significantly increased(P＜0.05).There were no significant differences in the incidence rates of poor villi maturation,thickening of dry villi arterioles and capillary filling in villi interstitial between the two groups(P＞0.05).Compared with the control group,the expression levels of IRS-1,GLUT4 and SNAP23 in placen-tal tissue of the probiotics group were significantly increased(P＜0.05).The incidence rates of neonatal hy-poglycemia and neonatal hyperbilirubinemia in the probiotics group were significantly lower than those in the control group(P＜0.05).Conclusion Compared with simple dietary intervention,probiotics combined with dietary intervention has more advantages in improving glucose and lipid metabolism of GDM patients,moreo-ver reduces the adverse events occurrence in newborns.

Humans ; Hematopoietic Stem Cell Transplantation ; Multiple Myeloma/therapy* ; Transplantation, Autologous ; Retrospective Studies ; Combined Modality Therapy ; Stem Cell Transplantation/adverse effects*

Objective:To explore the current situation and related factors of negative emotions in mothers of infants aged 0-3 years.Methods:Totally 1 183 mothers of 0-3-year-old infants in 3 communities of a districts and counties were selected.They were investigated with the self-designed demographic information questionnaire and the Depression Anxiety Stress Scale(DASS-21).Multiple linear regression analysis was used to explore the re-lated factors of mothers'negative emotions.Results:The detection rates of mild and above depression,anxiety and stress were 34.74％,46.07％and 18.10％respectively.The multiple linear regression analysis showed that moth-ers with fewer children,higher social prestige/stable occupation,and higher education were more depressed(β=-0.10,0.15,0.16).Mothers with higher social prestige/stable occupation and higher education were more anxious(β=0.14,0.17).Mothers who lived in areas with higher levels of economic and social development,or with higher social prestige/stable occupations and with higher education were more stressed(β=0.10,0.14,0.15).Conclu-sion:The mothers of 0-3-year-old infants have high detection rate of mild negative emotions.The residence,occu-pation,education level and the number of children are related to the negative emotions of mothers.

Abstract To study the antiviral effect ofZedoary TurmericOil Injection on novel coronavirus, SARS-CoV-2 viroid cell lines were preparedin vitroand treated with different concentrations of Zedoary Oil. The cell number and relative fluorescence value(RLU) were observed and measured, and the 50% effective inhibitory concentration(IC 50) was calculated. Four patients with Coronavirus Disease 2019 were clinically included, including 2 in the control group and 2 in the experimental group. The control group received conventional treatment, and the experimental group receivedZedoary TurmericOil Injection in addition to conventional treatment. The nucleic acid conversion rate, conversion time, pulmonary imaging changes, fever reduction time, clinical improvement time and adverse events of the patients were observed.In vitroexperiment, the relative fluorescence value decreased with increasing concentration ofZedoary TurmericOil, which was significantly different from that of the control group(P<0.05). The IC50 was 0.26 μg/ml.In vivostudy, the novel coronavirus nucleic acid in stool of case 1 in the test group turned negative in 3 days, the cough symptom of case 2 was significantly relieved, and there was obvious absorption in pulmonary imaging. The negative conversion time of novel coronavirus nucleic acid in the control group was 5 and 7 days respectively. No adverse events occurred in the experimental group.Zedoary TurmericOil had strong inhibitory effect on SARS-COV-2 virusin vitrowhich was dose-dependent.In vivotreatment of COVID-19,Zedoary TurmericOil Injection combined with conventional treatment can improve the cough caused by SARS-COV-2 infection, promote SARS-COV-2 to turn negative, promote absorption of lung lesions, and reduce lung injury, with no obvious adverse events.

We aimed to study the effect of allitridum (All) on the transient outward potassium current (Ito) of ventricular myocytes of spontaneously hypertensive rats (SHR). Totally 30 male SHRs were randomly divided into three groups: low-dose All group (7.5 mg·kg(-1)), high-dose All group (15.0 mg·kg(-1)) and normal saline group. The other 10 sex and age matched Wistar-kyoto rats (WKY) were also taken as control group (WKY group). All animals received i.p. administration for 8 weeks. The dual enzymatic method was used to separate single ventricular myocyte from animals. Patch-clamp technique was used to record Ito and analyze the effect of All on the current. It was shown that the left ventricular hypertrophy of SHR was reversed significantly by All. Furthermore, the density of Ito was recovered in both high and low dose All groups. The peak current densities of Ito were enhanced from 18.23±3.64 to 25.17±2.86 pA/pF (P<0.01) and 36.47±5.42 pA/pF (P<0.01) at +50 mV by All 7.5 mg·kg(-1) and 15.0 mg·kg(-1), respectively, which was not significantly different with WKY group. The effect was associated with positive shift of the steady-state, close-state inactivation, and shortened recovery from inactivation of Ito. It is concluded that All decreases the remodeling of Ito of ventricular hypertrophic myocytes of SHR.

OBJECTIVETo explore the clinical significance of ten-eleven-translocation methylcytosine dioxygenase 2 (TET2) mRNA expression levels in adult acute myeloid leukemia patients with normal cytogenetics (CN-AML).

METHODSExpression levels of TET2 mRNA were measured by real-time PCR in 157 adult CN-AML, and its clinical impact in CN-AML was evaluated as well.

RESULTSTET2 gene expression levels from bone marrow mononuclear cells (BMMNCs) [7.29(3.41-9.99)] and CD34+ cells [6.02(5.64-6.54)] in CN-AML were significantly lower than those [BMMNCs: 8.13(6.68-9.04), P=0.026; CD34+ cells: 6.48(5.97-7.12), P=0.034] in healthy control. And TET2 mRNA level at diagnosis [7.32(6.11-8.41)] was obviously lower than that at complete remission [8.39(7.76-8.79), P<0.01]. CN-AML patients with lower levels of TET2 mRNA showed worse survival rate [(32.7±5.9)%] at 18-month than those with higher levels [(48.6±6.9)%, P=0.041]. In multivariate analysis, lower level of TET2 mRNA was an independent prognostic factor for OS [hazard ratio(HR)2.032, 95% confidence interval (CI)1.272-3.247, P=0.003] and event-free survival [HR 1.532, 95% CI 1.014-2.314, P=0.043].

CONCLUSIONThe level of TET2 mRNA is significantly lower in patients with CN-AML and it is an independent negative prognostic factor. TET2 could be an important factor for the molecular-based risk stratification in CN-AML.

Adult ; Cytogenetic Analysis ; Cytogenetics ; DNA-Binding Proteins ; genetics ; Disease-Free Survival ; Gene Expression ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Proto-Oncogene Proteins ; genetics ; Real-Time Polymerase Chain Reaction

Objective To explore the value of helical computed tomography (CT) in differential diagnosis of xanthogranulomatous cholecystitis (XGC) and wall-thicked gallbladder cancer (GBC).Methods The CT signs of 18 XGCs and 20 wall-thicked GBCs were retrospectively analyzed.The maximum thickness of gallbladder wall, intramural hypoattenuated nodules, mucosal line of gallbladder inner wall,patterns of enhancement of thickened wall,whether combined with stones,the pericholecystic adjacent liver tissue involvement and biliary tract obstruction were observed.Measurement data were analyzed by independent sample t test and count date were analyzed by Fisher precisely the probability method.Results The mean maximum thickness of the gallbladder wall of XGC and wall-thicked GBC was (22.11±10.19) mm and (20.55±7.94) mm respectively,and there was no statistical significance (t=0.530,P=0.600).Eighteen cases of XGC and five cases of wall- thicked GBC patients were with intramural hypoattenuated nodules (Fisher precisely the probability method,P＜0.01 ),14 cases of XGC and six cases of GBC were with integrated mucosal line (Fisher precisely the probability method,P =0.004 ),three cases of XGC and 12 cases of GBC were with biliary tract obstruction (Fisher precisely the probability method,P=0.009).There was no statistical significance in the CT signs of the range of wall thickness,patterns of enhancement and enhanced degree of thickened wall,adjacent liver tissue involvement, lymphadenopathy, combined with gallbladder or bile duct stone between XGC and wall-thicked GBC patients (Fisher precisely the probability method,all P ＞ 0.05).Conclusions The thickened gallbladder wall with intramural hypoattenuated nodules and integrated gallbladder inner wall mucosal line were characteristic signs for diagnosing XGC.Helical CT scanning can provide evidence for differential diagnosis in XGC and wall- thicked GBC.

Objective To explore the effect of clinic professional nursing guidelines in nursing admini stration.Methods Clinic professional nursing guidelines were formulated according the specific condition in different apartment,the content includes two parts: routine disease care and symptom nursing guideline.Five departments of respiratory medicine,neurosurgery,oncology,orthopedic surgery and oncology radiation were randomly selected as studying subjects and the data was compared before and after guidelines.Results Neurosurgery was selected as a representation,basic nursing quality as(2.223 ±0.315),satisfaction degree was(41.26 ±3.25)before guideline and(3.122 ±0.214)and(46.12 ±5.26)after guideline respectively.The differences were statistically significant (t =21.833,12.740; P＜0.05 or ＜0.01).Conclusions Application of clinic professional nursing guidelines could standardize the nursing behavior and provide scientific,accurate,professional and practical nursing guidelines for first-line nurses,especially for those on further training,new graduate and new to switch department nurses,and raise the work effect and guarantee the work quality,reduce the nursing risk and ensure the nursing safe for them.

Objective To develop urine AD7C-NTP diagnostic kit,analyze and evaluate its application value on AD.Methods Immunogenicity AD7C-NTP peptide fragments had synthesized by solidphase methods.The animals immunized to prepare antibodies.After matching screening.mouse antibody was uesed as coating antibody.biotin-labeled rabbit antibody wag used as testing antibody,and horseradish peroxidase was labeied with avidin.The urine AD7C-NTP ELISA detective method was established.The AD7C-NTP levels in morning urine samples of 121 AD patients and 118 age-matched controls were collected.Results AD7C-NTP antibodies were identified.Mouse anti-AD7C-NTP antibody titer in ELISAwas 1:8 000,and rabbit anti-AD7C-NTP antibody titer in ELISA was 1:32 000:WB was uesd to detect human brain specimens and there was a single band with molecular weight of 41 000.The lowst detection limit of ELISA methodology was 0.5μg/L The linear range was 0-10μg/L,normal reference value ≤1.5μg/J,the average recovery rate was 100.2%.The intra and inter of CV were 3.8%,4.5%,7.6%,6.8% respectively.The AD7C-NTP levels[2.25(0.43-8.62)μg/L]of urine in AD group was higher than those in contorl group[0.82(0.47-2.77)μg/L,P<0.01].The positive rates in AD group and control group were 89.3% and 15.3% respectively.The sensitivity Was 89.3%and specificity was 84.7%.Conclusions The animals are immunized with the self-designed synthetic peptide fragment to prepare AD7C-NTP antibodies successfully.The established ELISA method for detection of urine AD7C-NTP with high sensitivity,and precision can be used as an assistant examination in clinical diagnosis of AD.