Objective To explore the pneumoperitoneum signs of neonates on the bedside abdominal lying film.Methods The pneumoperitoneum signs of 52 neonates on the bedside abdominal lying films were analyzed retrospectively.Results Among 52 neonates with pneumoperitoneum,2 cases had no perforation,and there were 50 cases of digestive tract perforation,with 22 cases of gastric perforation,17 cases of small intestinal perforation and 11 cases of large intestinal perforation.Congenital muscular defect of gastric wall and necrotizing enterocolitis(NEC)were the most common causes of perforation.Forty-three cases with anteroposterior films all had pneumoperitoneum signs;and in 9 cases with anteroposterior and lateral films,6 cases with anteroposterior and lateral films all showed pneumoperitoneum signs,while 3 cases showed pneumoperitoneum signs only on lateral films.Pneumoperitoneum signs included 38 episodes of liver falciform ligament signs,37 episodes of football signs,22 episodes of Rigler signs,21 episodes of round liver ligament signs,10 episodes of liver area bright shadows,9 episodes of inverted"V"signs,6 episodes of scrotal gas,5 episodes of triangular signs,4 episodes of Cupola signs and 1 episodes of dolphin sign.Two or more signs were seen in 46 cases and three or more signs were seen in 31 cases.There was no statistically significant difference in the pneumoperitoneum signs except for scrotal gas among the three groups of gastric,small intestinal and large intestinal perforations(P>0.05).Conclusion Various signs such as liver falciform ligament signs,football signs,Rigler signs and round liver ligament signs can be seen on the bedside abdominal lying film for neonates pneumoperitoneum,and understanding the above signs is conducive to rapid and accurate diagnosis.

Objective To investigate predictive value of serum levels of long noncoding RNA differentiation antagonizes non-protein coding RNA(LncRNA DANCR)and microRNA(miR)-33a-5p in patients with gestational diabetes mellitus(GDM)on pregnancy outcome.Methods A total of 154 GDM patients who underwent prenatal examination and delivery in the Fourth People's Hospital of Hengshui from August 2021 to February 2023 were collected as the GDM group,and these patients were grouped into a good outcome group of 115 cases and an adverse outcome group of 39 cases based on pregnancy outcomes.Meantime,149 healthy pregnant women with normal glucose tolerance test for 24 weeks were collected as the control group.Realtime fluorescence quantitative PCR(qRT-PCR)method was applied to detect serum LncRNA DANCR and miR-33a-5p levels,and receiver operating characteristic(ROC)curve was used to analyze the value of serum LncRNA DANCR and miR-33a-5p in predicting adverse pregnancy outcomes in GDM patients.Pearson correlation was applied to analyze the correlation among serum LncRNA DANCR,miR-33a-5p,fasting bloodglucos(FBG),fasting insulin(FINS),and homeostasis model assessment of insulin resistance(HOMA-IR)in patients with GDM adverse pregnancy outcomes.Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in GDM patients.Results The serum LncRNA DANCR level(0.69±0.15)in the GDM group was lower than that in the control group(1.01±0.22),while the level of miR-33a-5p(1.59±0.40)and the total incidence of adverse pregnancy outcomes(25.34％)were higher than those in the control group(1.02±0.23,5.36％),with significant differences(t/x2=14.835,15.140,23.011,all P＜0.05).The serum LncRNADANCR level(0.50±0.14)in the adverse outcome group was lower than that in the good outcome group(0.75±0.18),while miR-33a-5p(2.00±0.58),FBG(8.97±0.66mmol/L),FINS(18.63±1.31pmol/ml)and HOMA-IR(7.42±0.98)were higher than those in the good outcome group(1.45±0.26,8.01±0.59mmol/L,14.32±1.29pmol/ml,5.10±0.86),the differences were statistically significant(t=7.895～17.961,all P＜0.05).The areas under curve(AUC)of predicting adverse pregnancy outcomes in GDM patients with LncRNA DANCR and miR-33a-5p alone and in combination were 0.820,0.819 and 0.897,respectively.For patients with GDM adverse pregnancy outcomes,serum LncRNA DANCR was negatively correlated with FBG,FINS and HOMAIR(r=-0.498,-0.513,-0.509,allP＜0.05),while miR-33a-5p was positively correlated with FBG,FINS and HOMA-IR(r=0.517,0.494,0.507,all P＜0.05).LncRNA DANCR was a protective factor that affected adverse pregnancy outcomes in GDM patients(OR=0.804,95％CI:0.693～0.933,P=0.004);while miR-33a-5p was a risk factor for adverse pregnancy outcomes in GDM patients(OR=2.747,95％CI:1.444～5.225,P=0.002).Conclusion LncRNA DANCR was decreased and miR-33a-5p was increased in GDM patients with adverse pregnancy outcomes,indicating both may be influencing factors for adverse pregnancy outcomes.

A young female patient with acne and elevated testosterone level underwent plasma steroid hormones testing and found a significant increase in aldosterone. We excluded testing interference and verified the absence of hypertension, hypokalemia, and adrenal occupancy, as well as primary and secondary hyperaldosteronism. During follow-up, a temporal correlation was found between aldosterone levels and the use of drospirenone and ethinylestradiol tablets. It was observed that the combination of drospirenone and ethinylestradiol could lead to the increase of aldosterone level and the concentration ratio of aldosterone to direct renin through different mechanisms. Drospirenone exerts an antagonistic effect on mineralocorticoid receptor to prevent the development of hypertension or hypokalemia. In clinical practice, it is necessary to pay attention to the effect of this drug on screening markers for primary aldosteronism. In the laboratory examination, when female patients with no symptoms of hypertension and hypokalemia but with elevated aldosterone levels are encountered, it can be verified whether they have a history of use of compound estrogen-progestin such as drospirenone and ethinylestradiol tablets, and appropriate tips are provided in the report.

Objective:To explore the diagnostic application and characteristics of contrast-enhanced ultrasound in exertional rhabdomyolysis (ERM).Methods:Three cases of ERM patients admitted to Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital in August 2019 were selected and clinical data of the patients were collected including medical history, serum muscle enzyme, electromyography, magnetic resonance imaging (MRI) and dynamic contrast-enhanced ultrasound of the thigh muscles within one week after onset.Results:All three patients had muscle soreness and dark urine after exercise and their serum muscle enzyme level exceeded five times of normal value which could be definitely diagnosed as ERM. Skeletal muscle MRI showed equal or slightly longer T 1, longer fat-suppressed T 2 weighted fluid attenuated inversion recovery images, and high diffusion weighted imaging signal. In this group, one case of femur muscle MRI showed adductor longus and semitendinosus myopathy, other two cases showed quadriceps. All cases′ MRI score was grade one. Echogenic enhancement can be seen in normal ultrasound of diseased skeletal muscle. Contrast-enhanced ultrasound showed a dynamic strengthening process in which the central area was firstly strengthened, then strengthened in peripheral area. Dynamic contrast-enhanced ultrasound showed characteristic changes in ERM with early and obvious enhancement in the central area and uneven enhancement in the central area. Conclusions:Dynamic contrast-enhanced ultrasonography of ERM lesions has its characteristic changes. The enhancement of the central area of the lesion appeared early and obvious while the surrounding area appeared late and weak, showing the characteristic of "water ripple" concentric circle reinforcement. This enhancement characteristic suggested that ERM skeletal muscle was unevenly damaged and the central area was more obvious.

Objective To investigate associations of herpes simplex virus(HSV)infection with elevated high-sensitivity C-reactive protein(hsCRP)level and the development of atrial fibrillation(AF) in elderly individuals.Methods Through screening a total of 2,603 individuals,49 patients aged 60 years or over with AF and without structural heart diseases and known risk factors for AF were selected for data collection.Fifty-five elderly healthy control subjects were selected from a population based Chinese Arrhythmia Registry.Baseline characteristics,plasma antibody levels against HSV-1 and-2,and level of hsCRP were analyzed.Results Level of antibodies against HSV-1 was significantly higher in AF patients[(314.5±63.6)mg/L than in control subjects(216.0±50.7) mg/L,P＜0.01].Level of antibodies against HSV-2 was significantly higher in AF patients[(400.1±50.7) mg/L than in control subjects (306.3 ± 64.5) mg/L,P ＜ 0.01].Linear regression analysis demonstrated a positive correlation of plasma levels of hsCRP with both anti-HSV-1 and anti-HSV-2 IgG antibodies (r =0.291,0.188,all P ＜ 0.01).In multiple logistic regression analysis,HSV-1 and HSV-2 antibody levels were significantly associated with AF occurrence(OR =1.035 and 1.034,all P ＜0.01).The optimal cut-off point for predicting AF occurrence was 284.96 mg/L for anti-HSV-1 with sensitivity of 67.3％ and a specificity of 92.7％,and was 366.26 mg/L for anti-HSV-2 with a sensitivity of 67.3％ and a specificity of 85.5％,respectively.Conclusions The increased plasma levels of anti-HSV-1 and anti-HSV-2 antibodies are significantly associated with AF occurrence in elderly adults.

OBJECTIVETo investigate the prevalence of serum antibodies against Japanese encephalitis virus (JEV) in bats.

METHODSBlood samples from the heart were obtained from bats captured in Guangdong and Hainan Provinces in 2013. The anti-JEV antibodies in bat sera were tested using indirect ELISA and virus neutralization test.

RESULTSA total of 201 bat serum samples were tested, in which the total positivity rate of anti-JEV antibodies was 46.27% (93/201). The positive rate of anti-JEV antibodies in bats from Hainan and Guangdong Provinces was 88.89% (48/54) and 30.61% (45/147), respectively. All the samples from Rousettus leschenaultia, Miniopterus schreibersii, Pipistrellus abramus, and Rhinolophus macrotis were positive for anti-JEV antibodies, and up to 95.56% (43/45) of the samples from Miniopterus schreibersii (from Hainan Province) yielded positive results. Of the 28 samples with positive results by indirect ELISA, 15 showed positive results in virus neutralization test (53.57%) with neutralization antibody titers ranging from 1:10 to 1:28.22.

CONCLUSIONBats from different regions and of different species can be naturally infected with JEV and have a high prevalence of anti-JEV antibodies in their sera. The role of bats in the natural cycle of JEV awaits further study.

Animals ; Antibodies, Viral ; blood ; China ; Chiroptera ; immunology ; virology ; Encephalitis Virus, Japanese ; Enzyme-Linked Immunosorbent Assay ; Neutralization Tests

Objective To investigate the prevalence of serum antibodies against Japanese encephalitis virus (JEV) in bats. Methods Blood samples from the heart were obtained from bats captured in Guangdong and Hainan Provinces in 2013. The anti-JEV antibodies in bat sera were tested using indirect ELISA and virus neutralization test. Results A total of 201 bat serum samples were tested, in which the total positivity rate of anti-JEV antibodies was 46.27%(93/201). The positive rate of anti-JEV antibodies in bats from Hainan and Guangdong Provinces was 88.89% (48/54) and 30.61% (45/147), respectively. All the samples from Rousettus leschenaultia, Miniopterus schreibersii, Pipistrellus abramus, and Rhinolophus macrotis were positive for anti-JEV antibodies, and up to 95.56%(43/45) of the samples from Miniopterus schreibersii (from Hainan Province) yielded positive results. Of the 28 samples with positive results by indirect ELISA, 15 showed positive results in virus neutralization test (53.57%) with neutralization antibody titers ranging from 1∶10 to 1∶28.22. Conclusion Bats from different regions and of different species can be naturally infected with JEV and have a high prevalence of anti-JEV antibodies in their sera. The role of bats in the natural cycle of JEV awaits further study.

Objective To investigate the prevalence of serum antibodies against Japanese encephalitis virus (JEV) in bats. Methods Blood samples from the heart were obtained from bats captured in Guangdong and Hainan Provinces in 2013. The anti-JEV antibodies in bat sera were tested using indirect ELISA and virus neutralization test. Results A total of 201 bat serum samples were tested, in which the total positivity rate of anti-JEV antibodies was 46.27%(93/201). The positive rate of anti-JEV antibodies in bats from Hainan and Guangdong Provinces was 88.89% (48/54) and 30.61% (45/147), respectively. All the samples from Rousettus leschenaultia, Miniopterus schreibersii, Pipistrellus abramus, and Rhinolophus macrotis were positive for anti-JEV antibodies, and up to 95.56%(43/45) of the samples from Miniopterus schreibersii (from Hainan Province) yielded positive results. Of the 28 samples with positive results by indirect ELISA, 15 showed positive results in virus neutralization test (53.57%) with neutralization antibody titers ranging from 1∶10 to 1∶28.22. Conclusion Bats from different regions and of different species can be naturally infected with JEV and have a high prevalence of anti-JEV antibodies in their sera. The role of bats in the natural cycle of JEV awaits further study.

Objective To assess the clinical threatment results of pilon fractures managed with arthroscopyassisted minimally invasive percutaneous plate osteosynthesis (MIPPO).Methods 33 patients with pilon fractures were classified into 3 groups according to the Ruedi-Allgower classification:type Ⅰ in 26 cases,type Ⅱ in 5 cases,type Ⅲ in 2 cases,including 29 males and 4 females,aged 22 to 51 years,mean 31.5 years of age.All patients were treated with arthroscopy-assisted MIPPO with the postoperative follow-up time of 12 to 84 months.Results The clinical surgery efficacy according to Mazur's criterion was evaluated as excellent in 22 cases,good in 8 cases,fair in 3 cases.The excellent and good rate was 90.9％.Conclusion Arthroscopy-assisted MIPPO surgical treatment is an effective method for Pilon fractures with the advantages of good healing,minimal trauma and less complications,it is worthy of clinical application.

Objective To investigate the diagnosis and treatment of serous cystadenoma of the pancreas. Methods The clinical data of 18 patients with serous cystadenoma of the pancreas which were admitted into the First Affiliated Hospital of China Medical University from October 1999 to October 2010 were retrospectively analyzed. Results There were 15 females(83.3%) and 3 males (16.7%).Tumors were present in the pancreatic body and tail in 12 cases ( 66. 7% ), in the pancreatic head in 3 cases ( 16. 7% ) and in the pancreatic neck in 3 cases( 16. 7% ). The mean maximum diameter of the tumor was 6. 5 cm. No specific clinical features were indentified. The size of the tumor was significantly correlated with clinical symptoms. CT was main examination with correct diagnosing rate of 61.1%. All 18 patients received surgical resection. Pancreaticoduodenectomy was performed in 3 patients, distal pancreatectomy in 5 cases,spleen-preserving distal pancreatectomy in 5 cases, middle pancreatectomy in 3 cases, and tumor enucleation in 2 cases. Postoperative pancreatic fistula developed in 10 cases (55.6%);Fistula was healed by conservative therapy in all these 10 cases. Postoperative followed up from 6 to 125 months (mean,48. 3months) found no recurrence or metastasis. Conclusions CT was main imaging examination for serous cystadenoma of the pancreas. Surgical resection should be adopted for serous cystadenoma of the pancreas with clinical symptoms but uncertain malignancy.