Objective:To investigate the clinical characteristics of omphalocele, and to assess the risk factors associated with adverse outcomes.Methods:A retrospective cohort study was conducted. Clinical data of 224 patients diagnosed with omphalocele, who were hospitalized at Children′s Hospital, Zhejiang University School of Medicine from January 2013 to December 2022, were collected. Based on their discharge outcomes, the patients were classified into 2 groups: favorable outcomes and unfavorable outcomes. Chi-square test or continuity correction χ2 test or Fisher exact probability method, and Mann-Whitney U test were used for intergroup comparisons. Logistic regression analysis was performed to identify risk factors associated with adverse outcomes in omphalocele. Results:Among the 224 patients with omphalocele, 126 were male. A total of 208 patients (92.9%) had favorable outcomes, while 16 patients (7.1%) had unfavorable outcomes. In the unfavorable outcomes group, 14 patients had giant omphaloceles, while 100 patients had giant omphaloceles in the favorable outcomes group. The rates of herniation of more than two intra-abdominal organs in the hernial sac, congenital heart defects, patent ductus arteriosus, pulmonary hypertension, sepsis and infection of the hernial sac, were all higher in the unfavorable outcomes group compared to the favorable outcomes group (all P<0.05). Patients with unfavorable outcomes had longer mechanical ventilation time, duration of oxygen use, duration of parenteral nutrition, hospital stays, and higher rates of parenteral nutrition-associated cholestasis compared to those with favorable outcomes (all P<0.01). Multivariate Logistic regression analysis indicated that pulmonary hypertension ( OR=9.39, 95% CI 1.20-73.32), sepsis ( OR=8.59, 95% CI 1.32-55.86), and congenital heart defects ( OR=6.55, 95% CI 1.11-38.73) were all independent risk factors for adverse outcomes in omphalocele (all P<0.05). Conclusions:Infants with omphalocele are prone to complications such as cardiovascular malformations, infections, and pulmonary hypertension. Adverse outcomes in omphalocele are associated with pulmonary hypertension, sepsis, and congenital heart defects.

ObjectiveTo study the effect of Tanreqing injection （TRQ） on the pulmonary flora in the rat model of chronic obstructive pulmonary disease （COPD）. MethodWistar rats were randomized into control， model， and TRQ groups. The rats in other groups except the control group were treated by smoking combined with intratracheal instillation of lipopolysaccharide for the modeling of COPD. The TRQ group was intraperitoneally injected with TRQ （2 g·kg^-1）. At the end of the experiment， after blood collection from the abdominal aorta of the rats， the lung tissue was collected for hematoxylin-eosin and picric sirius red staining to reveal the pathological changes. The lung lavage fluid was collected， and the diversity and relative abundance of lung flora in different groups were analyzed by 16S rDNA amplicon sequencing. ResultThe lungs of the control group were normal， and those of the model group showed neutrophil infiltration， telangiectasia， lung hemorrhage and emphysema in individual cases， and thickening of collagen fibers in the trachea. Compared with the model group， the TRQ group showed significantly improved lungs and recovered collagen fibers. The MLI analysis showed that compared with the control group， the model group showcased increased alveolar space （P<0.01）， which was reduced in the TRQ group （P<0.05）. Compared with the control group， the model group showed increased wall thickness （P<0.01）， and the increase was attenuated in the TRQ group （P<0.01）. TRQ increased the Simpson index and altered the α diversity of pulmonary flora. The results of principal co-ordinate analysis showed that TRQ changed the β diversity and reduced the β diversity index of pulmonary flora. At the genus level， the model group showed increased relative abundance of g_Bacillus and g_Brevundimonas and decreased relative abundance of g_Pseudomonas， compared with the control group. After treatment with TRQ， the relative abundance of g_Stenotrophomonas increased， and that of g_Bacillus decreased. The LEfSe of differential taxa between groups showed that the modeling increased the relative abundance of g_Lachnospiraceae_NK4A136_group， and TRQ treatment increased the relative abundance of g_Rhodococcus and g_Stenotrophomonas. ConclusionTRQ can regulate the diversity of pulmonary flora and restore the balance of bacterial genera in the rat model of COPD， which may be one of the mechanisms of the prevention and treatment of COPD with TRQ.

OBJECTIVE To establish an ion chromatography method for the simultaneous determination of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）. METHODS The chromatographic column was a Dionex IonpacTM AS11-HC anion analysis column， with a Dionex IonPacTM AG11-HC guard column. The mobile phase was 10 mmol/L potassium hydroxide at an isocratic elution flow rate of 1.2 mL/min. The detector was a conductivity detector， and the suppressor was a Dionex AERS with a suppressor current of 30 mA. The column temperature was maintained at 30 ° C， and the injection volume was 10 μL. Chloride and sulfate contents were calculated by external standard method， while bicarbonate content was determined by double logarithmic fitting standard curve method. RESULTS Under these chromatographic conditions， chloride， sulfate and bicarbonate ions were effectively separated with linear ranges of 0.055 to 0.219 mg/mL （r＝0.999 9）， 0.155 to 0.618 mg/mL （r＝1.000 0）， and 0.065 to 0.121 mg/mL （r＝0.999 9）， respectively. The recoveries were 98.06% to 101.34%， 97.37% to 101.25%， and 97.16% to 99.81%， respectively， with RSDs of 1.1%， 1.3% and 1.0% （n＝9）. The RSDs for the evaluation of precision， accuracy， stability and ruggedness were all less than 2%. CONCLUSIONS The established ion chromatography is simple， rapid， accurate， precise and durable， can simultaneously determine the contents of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）， which is suitable for its quality control.

Objective:To analyze the epidemiological characteristics of human respiratory syncytial virus (HRSV) in patients with acute respiratory infection (ARIs) in sentinel hospitals of the Hubei influenza surveillance network from 2016 to 2023.Methods:ARIs samples [including influenza-like cases (ILI) and severe acute respiratory infection (SARI)] were collected from influenza surveillance sentinel hospitals in Hubei Province from 2016 to 2023, and case information was collected. HRSV virus nucleic acid typing was performed by fluorescence quantitative PCR method, and the data were collated, plotted and analyzed.Results:From 2016 to 2023, 12 779 cases of ILI and 9 166 cases of SARI were collected. The positive rate of HRSV was the highest in<5 years of age group [15.77% (168/1 065)], among which the positive rate was the highest in 2 to 5 years of age group of ILI cases [13.60% (31/228)], and the positive rate was the highest in 0 to 2 years of age group of SARI cases [25.97% (60/231)] (all P values<0.001). The positive rate of HRSV in SARI cases was 2.31%-25.97%, higher than that in ILI cases (0-13.60%) ( P=0.016). HRSV was prevalent in autumn and winter from 2016 to 2020 and in spring in 2023. Alternating epidemics of HRSV virus type A and B in Hubei Province from 2016 to 2023 (dominant epidemics of type B in 2016 and 2020; dominant epidemics of type A in 2017-2019 and 2023). Conclusion:SARI and ILI patients under five years old are the main infection groups of HRSV. The seasonal prevalence characteristics of HRSV in Hubei Province from 2016 to 2023 shift from autumn and winter to spring.

Objective:To analyze the epidemiological characteristics of human respiratory syncytial virus (HRSV) in patients with acute respiratory infection (ARIs) in sentinel hospitals of the Hubei influenza surveillance network from 2016 to 2023.Methods:ARIs samples [including influenza-like cases (ILI) and severe acute respiratory infection (SARI)] were collected from influenza surveillance sentinel hospitals in Hubei Province from 2016 to 2023, and case information was collected. HRSV virus nucleic acid typing was performed by fluorescence quantitative PCR method, and the data were collated, plotted and analyzed.Results:From 2016 to 2023, 12 779 cases of ILI and 9 166 cases of SARI were collected. The positive rate of HRSV was the highest in<5 years of age group [15.77% (168/1 065)], among which the positive rate was the highest in 2 to 5 years of age group of ILI cases [13.60% (31/228)], and the positive rate was the highest in 0 to 2 years of age group of SARI cases [25.97% (60/231)] (all P values<0.001). The positive rate of HRSV in SARI cases was 2.31%-25.97%, higher than that in ILI cases (0-13.60%) ( P=0.016). HRSV was prevalent in autumn and winter from 2016 to 2020 and in spring in 2023. Alternating epidemics of HRSV virus type A and B in Hubei Province from 2016 to 2023 (dominant epidemics of type B in 2016 and 2020; dominant epidemics of type A in 2017-2019 and 2023). Conclusion:SARI and ILI patients under five years old are the main infection groups of HRSV. The seasonal prevalence characteristics of HRSV in Hubei Province from 2016 to 2023 shift from autumn and winter to spring.

Objective To investigate the CT and MRI features of intraosseous myofibroma/myofibromatosis in pediatric patients.Methods The retrospective analysis involved the examination of clinical data and imaging findings from 15 children who were diagnosed with myofibroma/myofibromatosis of bone invasion through pathological means.Subsequently,the imaging characteristics were summarized.Results CT examinations were conducted on a total of 15 patients,with 2 of them also received enhanced scans.Additionally,MRI examinations were conducted on 5 patients,with 3 of them also underwent enhanced scans.Eleven patients were diagnosed with solitary type myofibroma,with 7 cases localized in the skull and the remaining lesions observed in the maxillofacial bone.Three patients exhibited the multicentric type without any involvement of visceral organs,while one patient presented with the multicentric type accompanied by visceral involvement.The lesions exhibited a uniform soft-tissue density on plain CT scan,predominantly located between the inner and outer layers of the bone.Additionally,they displayed swelling changes and osteolytic bone destruction,with some lesions showed residual bone shell.On MRI,the lesions exhibited a uniform signal,demonstrated an isointense or slightly hypointense signal on T1WI and an isointense or slightly hyperintense signal on T2WI.The lesions displayed significantly heterogeneous enhancement on CT and MRI.Conclusion The imaging manifestations of intraosseous myofibroma/myofibromatosis in pediatric patients exhibit certain characteristics,and the residual bone shell in the lesion is helpful for diagnosis,however,distinguishing it from Langerhans cell histiocytosis of the bone remains challenging,necessitating the reliance on pathological diagnosis.

Females increase aggression for mating opportunities and for acquiring reproductive resources. Although the close relationship between female aggression and mating status is widely appreciated, whether and how female aggression is regulated by mating-related cues remains poorly understood. Here we report an interesting observation that Drosophila virgin females initiate high-frequency attacks toward mated females. We identify 11-cis-vaccenyl acetate (cVA), a male-derived pheromone transferred to females during mating, which promotes virgin female aggression. We subsequently reveal a cVA-responsive neural circuit consisting of four orders of neurons, including Or67d, DA1, aSP-g, and pC1 neurons, that mediate cVA-induced virgin female aggression. We also determine that aSP-g neurons release acetylcholine (ACh) to excite pC1 neurons via the nicotinic ACh receptor nAChRα7. Together, beyond revealing cVA as a mating-related inducer of virgin female aggression, our results identify a neural circuit linking the chemosensory perception of mating-related cues to aggressive behavior in Drosophila females.
Animals ; Male ; Female ; Drosophila/physiology* ; Drosophila Proteins/physiology* ; Cues ; Sexual Behavior, Animal/physiology* ; Aggression/physiology* ; Drosophila melanogaster/physiology*

Objective·To explore the mechanism of changes in resistance to meropenem(MEM),a carbapenem drug,in Acinetobacter baumannii(A.baumannii)cultured in different antibiotic concentrations.Methods·Through changing the MEM concentration and other culture conditions of the standard sensitive strain of A.baumannii ATCC19606 and the clinical drug-resistant strain AB.2014,the derived strains with different levels of MEM-resistance were induced.The growth curves of all the stains were detected.DNA and RNA of them were extracted.PCR was used to analyze the expression of carbapenemase genes,including IMI,KPC,GES-1,IMP,VIM,NDM-1,OXA23,OXA24,OXA51,and OXA58.Real-time fluorescent quantitative PCR(RT-qPCR)was used to analyze the expression levels of the carbapenemase gene(OXA51),efflux pump genes(adeB,adeG,and adeJ),pore protein genes(carO,omp33-36,and oprC)and the penicillin-binding protein gene(ponA)in the A.baumannii strains with different resistance to MEM,of which the differential gene enrichment was also detected by whole genome sequencing and bioinformatics tools.Results·The 11 derived strains of ATCC19606 and AB.2014 with different levels of resistance to MEM were obtained,of which the minimum inhibitory concentrations(MIC)were 1-128 pg/mL.The growth rates and peak values of ATCC19606 and its derivatives decreased with the increase of drug resistance,but AB.2014 and its derivatives did not show this trend.ATCC19606 and its derived strains expressed 3 carbapenemase genes,i.e.,OXA51,VIM and IMP,while AB.2014 and most of its derived strains expressed 4 carbapenemase genes,i.e.,OXA23,OXA51,VIM and IMP,with only one sensitized derivative of AB.2014 losing OXA23 gene.RT-qPCR results showed that only in ATCC19606 and its drug-resistant derivatives,the expression level of oprC gene decreased with the increase of drug resistance,and the expression levels of most drug-resistant genes were consistent with the changes of drug resistance levels of the strains.Bioinformatics analysis indicated that the differential genes among different ATCC 19606 strains were mainly enriched in the siderophore uptake transmembrane transporter activity,cell outer membrane,bacterial secretion system and quorum sensing,while those among AB.2014 strains were mainly enriched in cell outer membrane,cellular response to chemical stimulus,atrazine degradation and RNA polymerase.Conclusion·The environmental pressure from carbapenems will cause the change of drug resistance of A.baumannii with the involvement of the genes of carbapenemases,efflux pumps,pore proteins and penicillin-binding proteins.The loss of carbapenemase gene OXA 2 3 may lead to the desensitization of drug-resistant A.baumannii strains to carbapenems.

More than 100 genes located on the X chromosome have been found to be associated with X-linked intellectual disability (XLID) to date, and NEXMIF is a pathogenic gene for XLID. In addition to intellectual disability, patients with NEXMIF gene mutation can also have other neurological symptoms, such as epilepsy, abnormal behavior, and hypotonia, as well as abnormalities of other systems. Two children with intellectual disability and epilepsy caused by NEXMIF gene mutation were treated in the Department of Pediatrics, Xiangya Hospital, Central South University from March 8, 2017 to June 20, 2020. Patient 1, a 7 years and 8 months old girl, visited our department because of the delayed psychomotor development. Physical examination revealed strabismus (right eye), hyperactivity, and loss of concentration. Intelligence test showed a developmental quotient of 43.6. Electroencephalogram showed abnormal discharge, and cranial imaging appeared normal. Whole exome sequencing revealed a de novo heterozygous mutation, c.2189delC (p.S730Lfs*17) in the NEXMIF gene (NM_001008537). During the follow-up period, the patient developed epileptic seizures, mainly manifested as generalized and absent seizures. She took the medicine of levetiracetam and lamotrigine, and the seizures were under control. Patient 2, a 6-months old boy, visited our department due to developmental regression and seizures. He showed poor reactions to light and sound, and was not able to raise head without aid. Hypotonia was also noticed. The electroencephalogram showed intermittent hyperarrhythmia, and spasms were monitored. He was given topiramate and adrenocorticotrophic hormone (ACTH). Whole exome sequencing detected a de novo c.592C>T (Q198X) mutation in NEXMIF gene. During the follow-up period, the seizures were reduced with vigabatrin. He had no obvious progress in the psychomotor development, and presented strabismus. There were 91 cases reported abroad, 1 case reported in China, and 2 patients were included in this study. A total of 85 variants in NEXMIF gene were found, involving 83 variants reported in PubMed and HGMD, and the 2 new variants presented in our patients. The patients with variants in NEXMIF gene all had mild to severe intellectual disability. Behavioral abnormalities, epilepsy, hypotonia, and other neurological symptoms are frequently presented. The phenotype of male partially overlaps with that of female. Male patients often have more severe intellectual disability, impaired language, and autistic features, while female patients often have refractory epilepsy. Most of the variants reported so far were loss-of-function resulted in the reduced protein expression of NEXMIF. The degree of NEXMIF loss appears to correlate with the severity of the phenotype.
Child ; Epilepsy/genetics* ; Female ; Humans ; Intellectual Disability/genetics* ; Male ; Muscle Hypotonia/complications* ; Mutation ; Phenotype ; Seizures/genetics* ; Strabismus/complications*

Objective:To demonstrate whether image quality and measurement accuracy of vessel wall thickening could be improved using a deep learning image reconstruction (DLIR) algorithm in children with Takayasu arteritis.Methods:From September 2019 to April 2020, 32 patients with Takayasu arteritis underwent low-dose contrast-enhanced CT with 100 kVp in Beijing Children′s Hospital were enrolled retrospectively. The raw data were reconstructed at 0.625 mm slice thickness using the filtered back projection (FBP), 50% adaptive statistical iterative reconstruction-V (ASIR-V) at 50% (50%ASIR-V), ASIR-V at 100% (100%ASIR-V) and DLIR. Subjective evaluation including the image quality of vessel wall identification, overall image noise and diagnostic confidence were evaluated using a 5 points scales by 2 observers. Objective evaluation including the thickness and standard deviation of vessel wall were measured, then the coefficient of variation (CV) was calculated. The CT value and noise of aorta were measured to calculate the contrast to noise ratio (CNR) of image. Friedman test was used to compare the differences of subjective scores among the four groups, and the analysis of variance of random blocks was used to compare the differences of objective measurement indices.Results:In terms of subjective score results, there was no significant difference between 100%ASIR-V and DLIR of overall image noise ( P>0.05), and the image scores of the two groups were higher than those of FBP and 50%ASIR-V (all P<0.05). The vessel wall identification and diagnostic confidence of DLIR were higher than those of other images (all P<0.05). The objective measurement results showed that the standard deviation and CV of vessel wall thickness in DLIR were significantly lower than those in other images (all P<0.05). There was no significant difference in vascular noise, muscle noise and CNR between 100%ASIR-V and DLIR (all P>0.05), which were lower than those in FBP and 50%ASIR-V (all P<0.05). Compared with 50%ASIR-V, the CV of DLIR was reduced by 22.9%, and the CNR was increased by 46.8%. Conclusion:DLIR can improve the overall image quality of CECT in children with Takayasu arteritis and the measurement accuracy of vascular wall, making it possible to further reduce the radiation dose.