Objective:To compare and explore the diagnostic performance of adding value of transabdominal and transvaginal contrast-enhanced ultrasound (CEUS) to Ovarian-Adnexal Reporting and Data System (O-RADS US) risk stratification and management system in differential diagnosis of adnexal masses.Methods:A total of 180 adnexal masses with solid components in 175 women were enrolled retrospectively between September 2021 and November 2022. All patients underwent routine Doppler ultrasound examinations and CEUS examinations. Among these masses, 107 masses underwent with transabdominal CEUS, 58 masses underwent with transvaginal CEUS, and 15 masses underwent both transvaginal and transabdominal CEUS. All patients were scheduled for surgery and pathological results served as the reference standard. Routine Doppler ultrasound and CEUS images and video were reviewed by a subspecialty radiologist using Vuebox software. The O-RADS US was downgraded or upgraded according to the CEUS characteristics of the masses. The diagnostic accuracy was assessed using ROC curve analysis. The area under the ROC curve (AUC) was calculated to compare the diagnostic performance of adding value of transabdominal and transvaginal CEUS to O-RADS US.Results:The diagnostic performance of adding transabdominal and transvaginal CEUS to O-RADS US were both significantly higher than of O-RADS US alone (transabdominal CEUS: AUC 0.83 vs 0.76, P=0.018; transvaginal CEUS: AUC 0.92 vs 0.81, P=0.013). Combination of transvaginal CEUS and O-RADS US was superior to that of combination of transabdominal and O-RADS US in the differential diagnosis of adnexal masses ( P=0.047). When the maximal diameter of adnexal masses ≤40 mm, transabdominal combined with O-RADS US presented the lowest diagnostic performance, with an AUC of 0.73. Conclusions:Combination of transvaginal CEUS and O-RADS US was superior to that of combination of transabdominal and O-RADS US in assessing adnexal masses with solid components. When the maximal diameter of adnexal masses ≤40 mm, transvaginal CEUS examination was recommended.

A 82-year-old man was admitted to hospital with fever,unresponsiveness,elevated hypersensitive C-reactive protein and neutrophile granulocyte.Ceftriaxone was administrated by intravenous dripping in the emergency room,but the effect was not satisfactory.Following his admission to the ward,cefoperazone sulbactam were given.Elizabethkingia meningoseptica was identified by blood culture and further confirmed by 16S rRNA sequencing.The lumbar puncture showed that cerebrospinal fluid pressure was 80 mmH2O(1 mmH2O=0.0098 kPa)and biochemical results were normal.After 11 days of cefoperazone sulbactam treatment,the patient was discharged with negative blood culture.The hypersensitive C-reactive protein and neutrophile granulocyte had also declined.The patient received levofloxacin tablets for anti-infection treatment for 14 d after discharge.No signs of infection were observed in three months'following up.

Objective To study the correlation between single nucleotide polymorphisms at loci rs4535211,rs75885714,and rs7653834 of phosphatidylinositol-specific phospholipase 2 (PLCL2) gene and large artery atherosclerotic (LAA) ischemic stroke.Methods A total of 105 patients with newly diagnosed LAA ischemic stroke admitted to the Second Affiliated Hospital of Xinjiang Medical University from July 2021 to July 2022 were selected as the observation group,and 103 patients with gender and age matching phys-ical examination in this hospital during the same period were selected as the control group. The clinical data and serum inflammatory markers were collected and compared between the two groups.Genotypes of PLCL2 gene rs4535211,rs75885714 and rs7653834 loci in the two groups were detected,and genotype and allele fre-quencies were calculated.Results The levels of C-reactive protein (CRP),interleukin-6 (IL-6),neutrophil to lymphocyte ratio (NLR),monocyte to high-density lipoprotein-cholesterol ratio (MHR),platelet to lympho-cyte ratio (PLR) and D-dimer in the observation group were higher than those in the control group.The level of high density lipoprotein-cholesterol (HDL-C) was lower than that of the control group (P<0.05). rs7653834 locus was C/C,C/T,T/T genotypes,and the difference between the two groups was statistically significant (P<0.05).The levels of C/C,T/C and T/T genotypes NLR and PLR at rs7653834 locus were sta-tistically significant between the two groups (P<0.05).The analysis results of co-dominant model,dominant model and overdominant model showed that there was statistical significance in rs7653834 locus genotype be-tween the two groups (P<0.05).Conclusion There may be a potential association between rs7653834 locus polymorphism of PLCL2 gene and LAA type ischemic stroke.

Objective:To investigate the risk factors of acute symptomatic seizures (ASS) and epilepsy in children with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).Methods:A ambispective cohort study was used including 74 children with MOGAD who were admitted to the Department of Pediatrics of Peking University First Hospital from January 2013 to June 2023 and were followed up. Demographic information, clinical information, treatment status, ASS and epilepsy status were collected. The clinical phenotypes were classified. According to the presence or absence of ASS in the course of disease, the children and the course of disease were divided into groups with and without ASS. Chi-square test, Fisher exact test and Mann Whitney U test were used to analyze the correlation between symptoms and auxiliary examination characteristics and the occurrence of ASS in the two groups of children. Multivariate Logistic regression analysis was used for multivariate analysis. Results:The onset age of the 74 children with MOGAD was 6.58 (3.80, 9.67) years, including 38 females (51.4%) and 36 males (48.6%). The duration of the final follow-up was 2.67 (1.10, 4.12) years, with a total of 239 times acute clinical episodes. ASS occurred in 39.2% (29/74) children during the course of disease and in 29.3% (70/239) of attacks. The common phenotypes were ADEM (67 times (28.0%)), optic neuritis (37 times (15.4%)) and cerebral cortical encephalitis (31 times (13.0%)) in 239 times acute clinical episodes. The incidence of ASS in ADEM and cerebral cortical encephalitis phenotype was 28.4%(19/67) and 100.0% (31/31), respectively. Multivariate analysis showed that cortical involvement on magnetic resonance imaging during clinical attacks was an independent risk factor for ASS ( β=-1.49, OR=0.23) after excluding attacks involving only optic nerve or spinal cord (49 episodes). During the follow-up, 5 children (6.8%) had epilepsy, and all children with epilepsy had multiple clinical attacks of MOGAD and previous ASS. Conclusions:Cortical involvement on magnetic resonance imaging during clinical episodes is an independent risk factor for ASS in children with MOGAD. All MOGAD children with epilepsy had ASS and multiple MOGAD clinical episodes in the past.

Perilla frutescens, an annual herb of the Labiatae family, has been cultivated in China for more than 2000 years. P. frutescens is the one of the first medicinal and edible plant published by the Ministry of Health. Its leaves, stems and seeds can be used as medicine and edible food. Because of the abundant nutrients and bioactive components in this plant, P. frutescens has been studied extensively in medicine, food, health care and chemical fields with great prospects for development. This paper reviews the cultivation history, chemical compositions and pharmacological activities of P. frutescens, which provides a reference for the development and utilization of P. frutescens resources.

ObjectiveTo analyze the surveillance results of influenza-like illness （ILI） cases in a sentinel hospital in Nantong from 2014 to 2021 and to understand the seasonal and etiological characteristics of influenza. MethodsThe routine ILI case information in a sentinel hospital in Nantong from 2014 to 2021 was collected from China Influenza Surveillance Information system， and the surveillance results were described and analyzed. ResultsA total of 64 110 ILI cases were reported in the hospital from 2014 to 2021， and accounted for 3.93% of outpatient and emergency visits. ILI is mainly concentrated in children under 15 years old， accounting for 55.39% of the total ILI cases. ILI% roughly showed two epidemic peaks in spring and winter. A total of 8 639 nasopharyngeal swab samples of ILI cases were collected during 2014‒2021， of which 838 were influenza positive， with an average positive rate of 10.01% （3.27%‒16.75%）. The epidemic strains varied from year to year and in different age groups. In 2014 and 2015， H3N2 influenza was the epidemic strain； in 2016 and 2017， H3N2 influenza and B-Victoria influenza were the co-epidemic strains； in 2018， H1N1 influenza was the epidemic strain； and in 2019‒2021， B Victoria influenza was the epidemic strain. The epidemic strain in 0‒4 years old， 15‒24 years old， 25‒59 years old and >60 years old was H3N2， and the epidemic strain in 5‒14 years old was B Victoria. There was a significant difference in the positive rate between different gender groups （χ²=7.364， P=0.006）. ConclusionInfluenza often occurs in winter and spring in a sentinel hospital in Nantong. Influenza subtypes are prevalent alternately in different age groups and different years. We need to closely monitor the etiology of influenza virus in Nantong to provide a basis for influenza prevention and control.

Objective:To investigate the intra- and inter-observer agreements of different experiencers using the Ovaria-adnexal Reporting and Data System (O-RADS) in the evaluation of adnexal masses.Methods:Totally 48 patients with adnexal masses (48 masses, mean size 9.5±4.7 cm, range 2.3-18.6 cm) found by ultrasound examination in the Third Affiliated Hospital of Sun Yat-sen University, from May 2019 to March 2020 were retrospectively analyzed. All the masses were confirmed by pathology or surgery. Four observers were divided into 2 senior doctors (Doctor 1 and Doctor 2) and 2 junior doctors (Doctor 3 and Doctor 4). Each observer independently evaluated adnexal masses twice using ultrasound O-RADS before and after systematic training, with an interval of 60 days. The intra-observer and inter-observer agreements were analyzed before and after training.Results:The inter-observer agreement between senior doctors were both excellent before and after systematic training (weight Kappa: 0.833 vs 0.802, percentage of agreement: 83.3% vs 81.3%). Whereas there was difference in the inter-observer agreement between non-experienced observers before and after training (weight Kappa: 0.399 vs 0.824, percentage of agreement: 50.0% vs 77.1%). After training, inter-observer agreement between junior doctors was significantly improved and comparable to senior (weight Kappa: 0.824 vs 0.802, percentage of agreement: 77.1% vs 81.3%). Before and after systematic training, the intra-observer agreements of the same doctor, the senior physicians were better than the junior (weight Kappa: 0.882 and 0.843 vs 0.440 and 0.605; percentage of agreement: 87.5% and 83.3% vs 58.3% and 54.2%).Conclusions:O-RADS risk classification system is a highly reproducible method in the subjective assessment of an adnexal mass among observers with varying levels of expertise. However, systematic training before clinical application is necessary and effective for non-experienced observers.

With the improvement of sanitation, the infection rate of hookworm is greatly reduced and the severe infected case is rarely reported. Combined morphological and molecular biological examinations, a severe hookworm infection patient was diagnosed in Department of Laboratorial Examination, Quanzhou First Affiliated Hospital of Fujian Medical University. The morphological methods such as direct fecal smear microscopy, saturated brine flotation and hookworm larvae culture methods were used to identify the eggs and larvae from stool samples of the patient. There were a large number of hookworm eggs in patient's stool samples, and the average count was 60 840 per gram by modified Kato method, which belonged to severe hookworm infection. Meanwhile, to distinguish the hookworm species, the semi-nested RT-PCR assay was employed to detect hookworm internal transcribed spacer series from eggs in patient's stool samples, and the result showed that the hookworm species was confirmed to be Necator americanus.
Ancylostomatoidea/genetics* ; Animals ; Feces ; Hookworm Infections/diagnosis* ; Humans ; Necator americanus/genetics* ; Polymerase Chain Reaction

BACKGROUND: Idiopathic scoliosis (IS) affects patients' quality of life, yet there have been few reports of its morphology and epidemiological study in the southeast region of China. The aim of this study is to access the curve characteristics, prevalence, and factors associated with IS in Chaozhou city. METHODS: A cross-sectional study was performed in 2018, in which scoliosis screening was conducted among 5497 primary school students in Chaozhou city. Then, a case-control study based on the screening involving 2547 children was followed for the exploration of the associated factors. The questionnaires covering demographic characteristics, postural habits, cognition and self-sensation of scoliosis, and physical conditions were addressed for the investigation. ORs with 95%CIs were calculated based on logistic regression analysis to evaluate the factors associated with scoliosis. RESULTS: The prevalence of IS among primary school students was 6.15% in Chaozhou city, with 4.04% for males and 8.71% for females. The average Cobb angle was 15° (range 8 to 37°). Multiple logistic regression analysis suggested that female (OR=2.45), BMI (OR=0.67), having myopia (OR=1.49), self-sensation of scoliosis with symptoms (OR=5.52), insufficient sleep time (OR=2.65, 3.33), and less exercise time (OR=7.09, 7.29) were significantly associated with IS. CONCLUSIONS The prevalence of IS among primary school students in Chaozhou was at an average level, and it was significantly higher in females than in males. Lower body mass, having myopia, insufficient sleep time, and lower physical activity were associated with IS.
Case-Control Studies ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Epidemiologic Studies ; Female ; Humans ; Male ; Myopia/complications* ; Risk Factors ; Schools ; Scoliosis/physiopathology* ; Students

Chimeric antigen receptor T (CAR-T) cell has achieved excellent efficacy in hematological tumors, especially for lymphoma. Many products have been approved to market all over the world, and 2 products targeting CD19 have been approved to treat relapsed and refractory large B-cell lymphoma in China. The current experiences of using CAR-T cells come from previous clinical studies. How to use CAR-T cells in a standardized and rationalized way is still a challenge faced by our clinicians. Based on the CAR-T cell treatment experiences from Peking University Cancer Hospital and the latest research progresses in CAR-T in China and abroad, this article will elaborate on patient screening, peripheral blood mononuclear cell collection, bridging treatment, lymphocyte depletion chemotherapy, CAR-T cell infusion, the monitoring and treatment of adverse events after infusion, and long-term follow-up after infusion, in order to guide clinicians to better use CAR-T cell and to bring maximum benefits to patients.