Objective:To identify and characterize one Yokenella regensburgei strain(designated as CXLZQ123) isolated from a case of perionychial abscess. Methods:Strain CXLZQ123 was isolated from a patient with periungual abscess at the Dermatology Department of San County Central Hospital in June 2, 2023. The strain was initially identified through morphological and biochemical tests, followed by mass spectrometry identification, 16S rRNA sequencing and whole-genome sequencing. MEGA 11.0 was used to compare and analyze the strain′s genetic relationship with relevant species in GenBank, and a phylogenetic tree was constructed based on genetic distance to analyze its genetic evolution. Meanwhile, the average nucleotide identity between its genome and similar strains were compared.Results:The strain was identified as a Gram-negative rod. MicroScan WalkAway biochemical tests indicated that the strain was either Yokenella regensburgei (91.47%) or Hafnia alvei (8.53%). MALDI-TOF mass spectrometry confirmed it as Yokenella regensburgei. Based on 16S rRNA gene sequence analysis, the strain showed the highest similarity(99.37%) to CIP 105435 (sequence number NR_104934.1). The 16S rRNA gene sequence of the isolated strain Yokenella regensburgei was submitted to the National Center for Biotechnology Information (NCBI) with the GenBank sequence number of OR230248.1. The whole-genome of CXLZQ123 were sequenced and uploaded (NCBI, SRA sequence number: SRR26510420). The average nucleotide identity between CXLZQ123 and Yokenella regensburgei strains W13 and UU2206353 were 98.82% and 99.04%, respectively. Conclusions:Through morphological observation, biochemical identification, mass spectrometry identification, 16S rRNA and whole-genome sequencing, this pathogenic strain is identified as Yokenella regensburgei. This rare bacterium is sensitive to most detected antibiotics. This study provides diagnostic and treatment experience for Yokenella regensburgei-related infections.

Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is an extremely rare, indolent skin malignancy that can be difficult to distinguish from autoimmune disease-associated panniculitides. Here, we describe a 12-year-old boy who was diagnosed at age 7 years with dermatomyositis with classical manifestations, including poikiloderma, Gottron’s sign, and symmetric muscle weakness. Recently, the boy presented multiple subcutaneous nodules and fever. Histopathological examination and immunohistochemical staining revealed coexistence of SPTL. To our knowledge, this is the first case of dermatomyositis accompanied with SPTL. This case alert clinical physicians of the possibility of SPTL should be considered when a patient with dermatomyositis has new lesions presenting as nodules and unknown fever.

Objective To establish a mathematical model of tumor growth and invasion under radiotherapy, so as to numerically simulate the effect of radiotherapy on tumor growth and make sensitivity analysis.Methods The mathematical model of tumor growth and invasion with time evolution before and after radiotherapy was established. The model included four key variables in the process of tumor invasion: tumor cells, extracellular matrix (ECM), matrix-degradative enzymes (MDEs) and oxygen. The linear quadratic (LQ) model was used to simulate the survival probability of tumor cells after radiotherapy, and the effects of different radiotherapy schemes and radiotherapy coefficients on the treatment effect were discussed. Traditional radiotherapy and intraoperative targeted radiotherapy were compared.Results Under the premise of constant total dose, the results of radiotherapy were directly proportional to the radiotherapy coefficient, but not related to the radiotherapy frequency; the therapeutic effect of intraoperative targeted radiotherapy was better than that of standard treatment.Conclusions Simulation results are basically consistent with clinical experimental results. As a more efficient treatment method, intraoperative targeted radiotherapy can provide new ideas for clinical tumor treatment.

Objective:To investigate the correlation between myocardial infarction and carotid atherosclerosis in older adult patients.Methods:A total of 98 older adult patients with myocardial infarction who received treatment in Lishui People's Hospital from June 2020 to June 2021 were included in this study. They were divided into three subgroups: mild ( n = 25), moderate ( n = 43) and severe ( n = 30) groups according to the severity of myocardial infarction. An additional 50 healthy subjects who concurrently received physical examination in the same hospital were included as controls. All participants underwent color Doppler ultrasound to evaluate the degree of carotid stenosis and its correlation with the severity of myocardial infarction. Results:In the myocardial infarction group, 327 carotid plaques were detected in 88 out of 98 patients, with the detection rate of 89.8%. In the control group, 85 carotid plaques were detected in 17 out of 50 healthy subjects, with the detection rate of 34.0%. In the myocardial infarction group, most plaques were mixed and soft, accounting for 34.8% (114/327) and 51.4% (168/327), respectively. In the control group, most plaques were calcified, accounting for 62.3% (53/85). There was significant difference in plaque property between the two groups ( χ2 = 102.23, P < 0.05). There was significant difference in the degree of carotid lumen stenosis between control and myocardial infarction groups ( χ2 = 60.07, P < 0.05). The degree of carotid lumen stenosis increased with the aggravation of myocardial infarction ( χ2 = 15.17, P < 0.05). Carotid intima-media thickness in the severe group was (1.49 ± 0.26) mm, which was significantly greater than (1.28 ± 0.24) mm in the moderate group, (1.15 ± 0.21) mm in the mild group and (0.82 ± 0.16) mm in the control group ( t = 5.21, 7.42, 14.29, all P < 0.05). Plaque score in the severe group was (2.56 ± 0.51) points, which was significantly higher than (2.33 ± 0.45) points in the moderate group, (1.58 ± 0.39) points in the mild group, and (1.12 ± 0.36) points in the control group ( t = 3.00, 11.23, 14.77, all P < 0.05). Correlation analysis showed that the severity of myocardial infarction was positively correlated with the degree of carotid artery lumen stenosis, intima-media thickness and plaque score ( r = 0.41, 0.33, 0.28, all P < 0.01). Conclusion:The severity of myocardial infarction in the older adults is correlated with carotid atherosclerosis, and carotid lumen stenosis can be used as a predictor of myocardial infarction.

Objective:To analyze the correlation between phonographic cardiac function and uterine artery resistance index (RI) in pregnant women with hypertension of different conditions during pregnancy by color Doppler ultrasonically.Methods:A total of 100 pregnant women with gestational hypertension admitted to Lishui People′s Hospital from January 2020 to February 2021 were selected and divided into gestational hypertension group (40 cases), mild pre-eclampsia group (30 cases) and severe pre-eclampsia group (30 cases) according to the severity of their disease. Another 30 normal pregnant women who underwent physical examination during the same period were selected as the control group. The left ventricular function parameters isovolumetric relaxation time (IVRT), left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume(LVESV), left atrial volume index (LAVI) and uterine arter RI in 4 groups were quantitatively analyzed by ultrasound during 28 to 38 weeks of gestation. The correlation between cardiac ultrasound parameters and of pregnant women RI were analyzed.Results:As the severity of the disease, the levels of IVRT, LVEDV, LVESV, LAVI were gradually rised, and the level of LVEF was gradually decreased, there were significant differences among the 4 groups ( P<0.05). The uterine arter RI in the control group, gestational hypertension group, mild pre-eclampsia group and severe pre-eclampsia group was 0.42 ± 0.04, 0.50 ± 0.05, 0.54 ± 0.11, 0.58 ± 0.06, there was significant difference ( F = 34.11, P<0.001), and as the severity of the disease , the level of uterine arter RI was gradually rised, there were significant differences among the 4 groups ( P<0.05). Pearson correlation analysis showed that IVRT had certain correlation with RI in the 4 groups ( r = 0.331, 0.450, 0.531, 0.582; P<0.05). In mild and severe pre-eclampsia group, there were a certain correlation between LVEDV, LVESV and RI (in mild pre-eclampsia group: r = 0.360 and 0.411, P<0.05; in severe pre-eclampsia group: r = 0.383 and 0.451, P<0.05). Conclusions:The left heart function of pregnant women with different conditions evaluated by ultrasound showed a downward trend, and the uterine artery RI increased gradually in pregnant women with severe pre-eclampsia, and RI was closely related to the cardiac ultrasound parameter IVRT.

Objective:To investigate the clinic diagnostic value of multi-slice CT (MSCT) imaging features in various subtypes of nodular lung adenocarcinoma.Methods:The imaging information and general clinical data of 160 patients with nodular lung adenocarcinoma who were admitted to Yantai Affiliated Hospital of Binzhou Medical University and received surgical treatment from January 2017 to May 2019 were retrospectively analyzed. Univariate analysis was used to screen statistically significant imaging features of each pathological subtype, and binary logistic regression analysis was performed. The diagnostic value was analyzed using the receiver operating characteristic (ROC) curve, the area under the curve (AUC) was calculated, and the diagnostic efficacy was compared.Results:The age of patients with atypical adenomatous hyperplasia and adenocarcinoma in situ (AAH+ AIS), minimally invasive ademocarcinoma (MIA), invasive adenocarcinoma cancer (IAC) and variant of invasive adenocarcinoma cancer (VIAC) were (57.07±7.92), (59.37±6.96), (60.68±8.83), (63.33±6.89) years old, with no statistically significant difference ( F=1.221, P=0.304). The age of patients with VIAC, IAC, MIA and AAH+ AIS decreased in turn. The imaging features of AAH+ AIS, MIA, IAC and VIAC that exhibited statistically significant differences were as following in turn: the maximum diameter of lesion [6.85 (3.73) mm vs. 8.00 (5.00) mm vs. 16.00 (11.90) mm vs. 17.20 (9.08) mm, H=55.107, P<0.001], CT value [-563.50 (176.63) HU vs. -536.00 (293.50) HU vs. -235.50 (346.50) HU vs. -23.00 (30.50) HU, H=47.499, P<0.001], solid ratio [0 (0) vs. 0 (0) vs. 49.00% (100.00%) vs. 100.00% (0), H=44.242, P<0.001], vacuolar sign [14 (87.50%) vs. 35 (100.00%) vs. 84 (81.55%) vs. 3 (50.00%), χ2=13.925, P=0.002], inflatable bronchus sign [1 (6.25%) vs. 2 (5.71%) vs. 36 (34.95%) vs. 2 (33.33%), χ2=16.578, P=0.001], intratumoral vascular sign [13 (81.25%) vs. 28 (80.00%) vs. 64 (62.14%) vs. 1 (16.67%), χ2=11.168, P=0.009], vessel convergence sign [1 (6.25%) vs. 3 (8.57%) vs. 66 (64.08%) vs. 6 (100.00%), χ2=54.232, P<0.001], short burr sign [3 (18.75%) vs. 11 (31.43%) vs. 77 (74.76%) vs. 6 (100.00%), χ2=36.218, P<0.001], lobulation sign [4 (25.00%) vs. 18 (51.43%) vs. 93 (90.29%) vs. 6 (100.00%), χ2=43.302, P<0.001], pleural traction sign [0 (0) vs. 6 (17.14%) vs. 70 (67.96%) vs. 5 (83.33%), χ2=50.794, P<0.001]. The maximum diameter of lesion ( OR=0.858, 95% CI: 0.754-0.977, P=0.021) and pleural traction sign ( OR=0.288, 95% CI: 0.084-0.993, P=0.049) were independent influencing factors of MIA. The maximum diameter of lesion ( OR=1.131, 95% CI: 1.030-1.241, P=0.010) and pleural traction sign ( OR=3.441, 95% CI: 1.279-9.254, P=0.014) were independent influencing factors of IAC. The optimum threshold of the maximum diameter of lesion in diagnosis of MIA was 11.05 mm, AUC was 0.798 (95% CI: 0.724-0.872) sensitivity was 68.00%, and specificity was 85.70%. The AUC of pleural traction sign in diagnosis of MIA was 0.714 (95% CI: 0.623-0.806). The diagnostic efficacy exhibited no statistically significant difference between the maximum diameter of lesion and pleural traction sign in diagnosis of MIA ( Z=1.838, P=0.066). The optimum threshold of the maximum diameter of lesion in diagnosis of IAC was 11.05 mm, AUC was 0.827 (95% CI: 0.759-0.895), sensitivity was 75.70%, and specificity was 78.90%. The AUC of pleural traction sign in diagnosis of IAC was 0.743 (95% CI: 0.663-0.823). The diagnostic efficacy exhibited statistically significant difference between the maximum diameter of lesion and pleural traction sign in diagnosis of IAC ( Z=2.114, P=0.035), and the maximum diameter of lesion > 11.05 mm was better for the diagnosis of IAC. Conclusion:The maximum diameter of lesion and pleural traction sign are independent influence factors in diagnosis of MIA and IAC, and the maximum diameter of lesion > 11.05 mm is better for the diagnosis of IAC.

Objective:To explore the positive rates of 2019-nCoV nucleic acid at different time of courses of COVID-19.Methods:Patients with confirmed COVID-19 were enrolled in this study. Nasal and throat swabs were collected from different courses of disease. Real-time RT-PCR was used to detect 2019-nCoV nucleic acid.Results:From January 23 to February 20, 2020, a total of 120 confirmed cases of COVID-19 were reported in Xi’an, and 85 cases(70.83%) were positive in first detection. The COVID-19 cases included consistently nucleic acid positive and intermittently nucleic acid positive patients. 2019-nCoV nucleic acid could be detected in incubation period, and the longest observed duration of nucleic acid positive in this study was 26 days. The positive rate of 2019-nCoV nucleic acid was up to 84.21% on the 6th day, and the positive rate decreased as time passed during the course of COVID-19. Three patients (2.86%) were tested positive for 2019-nCoV nucleic acid again in nasal and throat swabs after discharge.Conclusions:The positive rate of 2019-nCoV nucleic acid was higher in the early stage of disease. 2019-nCoV nucleic acid can be detected in incubation period, and virus shedding may last for a long period.

Acute ischemic stroke has ischemic penumbra and actual infarct core, and when there is a bigger difference in the volume of the two, it is called " mismatch". It is not only manifested as a mismatch between the clinical manifestations and the infarct core, but also as a mismatch between the infarct core and the perfusion area. The advancement of neuroimaging technology enables this " mismatch" phenomenon to be manifested through different imaging methods or different sequences of the same imaging method, thereby providing more guidance for the further diagnosis and treatment process.

Objective To investigate the clinicopathologic characteristics and prognosis of medullary breast carcinoma.Methods We conducted a retrospective analysis on clinical and pathologic data of 166 patients with medullary breast cancer.Results All the patients were female with a median age of 52 years old.The proportion of patients with stage Ⅰ,Ⅱ and Ⅲ disease was 16.9％,68.1％,15.0％,respectively.The Luminal,HER-2 overexpressing and triple-negative subtypes constituted 31.3％,8.4％,and 60.3％,respectively.There was significant difference in regional lymph node status of medullary breast cancer patients with different molecular types (x2 =18.248,P =0.003),but not in tumor size,TNM stage,histological grade,and expression of Ki67 (all P ＞ 0.05).Multivariate survival analysis indicated that TNM stage was an independent predictor in the prognosis of medullary breast cancer (HR =5.664,P =0.001).All the patients were followed up from 15 months to 145 months with a median follow-up time of 108 months.The 5-year survival rate was 91.5％ and the 10-year survival rate was 87.2％.Conclusions The prognosis of medullary breast cancer is favorable.Personalized treatment according to the TNM stage and histopathologic characteristics achieve a favorable prognosis.

[ABSTRACT]OBJECTIVETo study the expressions of 34βE12, Galectin-3 and HBME-1 in thyroid nodules, and to explore its diagnostic value for papillary thyroid carcinoma (PTC).METHODSEn VisionTM immunohistochemical technique was used to detect the expression of 34βE12, Galectin-3 and HBME-1 in 352 thyroid lesions. The correlation between the expressions of the 3 protein markers and clinicopathological characteristics was evaluated. The receiver operating characteristic area under the curve (ROC-AUC) and their index for diagnosis evaluation were also calculated.RESULTSThe positive rates of 34βE12, Galectin-3 and HBME-1 in 246 PTC lesions were significantly higher than those in benign nodules (P<0.001). There was no relationship between the expression of the 3 protein markers and clinicopathological characteristics (eg. gender, age, numbers of lesions, tumor size, capsular invasion, lymph node metastasis, TNM staging). The ROC-AUC of 34βE12, Galectin-3 and HBME-1 for diagnosis of PTC was 0.936, 0.915 and 0.898 respectively. The sensitivity of 34βE12, Galectin-3 and HBME-1 for diagnosis of PTC was 94.3%, 95.5% and 91.1% respectively, while the specificity was 81.1%, 71.7% and 83.0% respectively, and the diagnostic accuracy rate was 90.3%, 88.4% and 88.6% respectively.CONCLUSION The expressions of 34βE12, Galectin-3 and HBME-1 are statistically different between PTC and benign lesions, but no associations are found with clinicopathological characteristics, indicating the three protein markers have important diagnostic value for PTC.