Child ; Humans ; Mpox (monkeypox)/prevention & control* ; Disease Outbreaks

Objective To analyze the predictive value of serum levels of procalcitonin(PCT)and cytokines on the prognosis of patients with COVID-19 at admission.Methods From November 2022 to February 2023,patients diagnosed with COVID-19 who were admitted to Beijing Chest Hospital were enrolled.Chemiluminescence was used to detect serum PCT levels,and flow microsphere array was used to detect serum cytokines IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17A,IL-17F,IL-22,TNF-α,TNF-β,IFN-γ level.ICU admission,mechanical ventilation and in-hospital death were defined as poor prognosis.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.Results A total of 176 patients with complete data were included,including 134 in the PCT-normal group and 42 in the PCT-elevated group,with a median age of 71.50 years and 71.59%males.Patients in the PCT elevated-group had significantly higher rates of ICU admission(38.41%vs.13.11%,P<0.05),mechanical ventilation(76.92%vs.24.59%,P<0.001)and in-hospital mortality(38.46%vs.6.56%,P<0.001)were significantly higher than those in the PCT-normal group.Serum levels of cytokines IL-6(7.40 pg/mL vs.4.78 pg/mL,P = 0.033 4)and IL-8(10.97 pg/mL vs.5.92 pg/mL,P<0.001)were significantly higher in patients with poor prognosis than in those with good prognosis.The area under the curve for PCT,IL-6,and IL-8 to predict poor prognosis in COVID-19 patients was 0.687,0.660,and 0.746,respectively;sensitivity was 52.78%,55.17%,and 72.41%,respectively;and specificity was 81.58%,74.19%,and 74.19%,respectively,as calculated from the ROC curve.When PCT,IL-6 and IL-8 jointly predict the prognosis of COVID-19 patients,the area under the curve is 0.764,the sensitivity is 70.00%,and the specificity is 80.00%.Conclusion Serum PCT and cytokines IL-6 and IL-8 could be used as predictive markers for poor prognosis in patients with COVID-19.

[Objective]To explore the efficacy of Solifenacin in the treatment of children with idiopathic overactive bladder(OAB).[Methods]The study included 67 children with idiopathic OAB treated in the urology clinic of our hospital from March 2022 to March 2023.After at least 2-week-long behavioral therapy showed no significant therapeutic effect,52 of the cases in the trial group were given oral Solifenacin 5 mg once daily and the other 15 cases in the control group con-tinued the behavioral therapy.The cases in trial group were subdivided into OAB-dry group(27 cases without urinary in-continence)and OAB-wet group(25 cases with urinary incontinence).The 3-day micturition diary,OAB Symptom Scores(OABSS)and the adverse reactions were recorded and analyzed before,at Weeks 2,4,8 and 12 after the treat-ment.[Results]Of all the 67 cases who completed a 3-month follow-up,44 were cured including 41 in the trial group and 3 in the control group,4 presented with adverse reactions.After the 3-month follow-up,the OABSS declined markedly in trial group than in control group(Z=4.524,P<0.001);the cure rates in trial group and control group are 78.8%and 20%respectively,with significant difference(χ2=15.367,P<0.001).At each follow-up,we found increased mean voided vol-ume(F=9.707,P<0.001),reduced mean voiding frequency during daytime(F=3.837,P=0.009)and decreased voiding urgency(χ2=482.835,P<0.001).After the 3-month follow-up,the cure rates in OAB-dry group and OAB-wet group are 81.5%and 76%respectively,with no significant difference(χ2=0.234,P=0.629).[Conclusions]In children with idiopath-ic OAB,oral Solifenacin 5 mg once daily could significantly increase mean voided volume,reduce mean voiding frequency during daytime,relieve symptoms of urinary urgency and lead to fewer adverse reactions,but is not significantly effective for the treatment of urinary incontinence in OAB-wet children.

Objective To observe the effect of canagliflozin combined with enalapril on diabetic nephropathy(DN).Methods DN patients were randomly divided into control group and treatment group.All patients in 2 groups received basic treatment of recombinant human insulin injection,and the control group was orally administered enalapril tablet 10 mg(qd).The treatment group was given orally canagliflozin tablet 100 mg(qd)on the basis of the control group.Both groups were treated for 8 weeks.Renal function,blood glucose index,serum vascular endothelial growth factor(VEGF),transforming growth factor-β(TGF-β),homocysteine(HCY)levels,clinical efficacy and incidence of adverse drug reactions were compared between 2 groups.Results There were 71 cases were included in the control group and 73 cases in the treatment group.After treatment,β2 microglobulin(β2-MG)in treatment group and control group were(0.21±0.03)and(0.28±0.04)mg·L-1;blood urea nitrogen(BUN)were(4.23±0.42)and(5.58±0.65)mmol·L-1;serum creatinine(SCr)were(89.32±8.29)and(101.25±10.18)pmol·L-1;24 h microalbumin(mAlb)were(49.38±5.06)and(58.21±6.43)mg;glycosylated hemoglobin(HbA1c)were(6.10±0.11)％and(6.45±0.16)％;2 h postprandial blood glucose levels were(6.05±0.78)and(7.68±1.82)mmol·L-1;fasting blood glucose(FBG)were(5.02±0.32)and(5.67±0.65)mmol·L-1;VEGF levels were(350.18±20.04)and(389.04±24.16)pg·mL-1;TGF-β were(148.32±16.57)and(168.24±20.02)pg·mL-1;HCY were(13.12±2.38)and(19.35±3.21)pmol·L-1,the differences were statistically significant(all P＜0.05).After treatment,the total effective rate of treatment group and control group were 83.56％(61 cases/73 cases)and 67.61％(48 cases/71 cases),the difference was statistically significant(P＜0.05).The total incidence of adverse drug reactions in treatment group and control group were 6.85％and 4.23％,with no significant difference(P＞0.05).Conclusion Canagliflozin combined with enalapril is effective in the treatment of diabetic nephropathy,which can improve renal function,regulate blood glucose metabolism,and down-regulate serum VEGF,TGF-β and HCY levels,and is safe and reliable.

Objective:To retrospectively analyze the clinical characteristics and prognosis of 85 newly diagnosed patients with follicular lymphoma (FL), as well as the prognostic value of comprehensive geriatric assessment (CGA) in patients with FL aged ≥ 60 years old.Methods:The clinical data and prognosis of 85 newly diagnosed FL patients admitted from August 2011 to June 2022 were collected. The clinical features, laboratory indicators, therapeutic efficacy, survival and prognostic factors of patients were statistically analyzed, and the prognosis of patients was stratified using various geriatric assessment tools.Results:① The patients with FL were mostly middle-aged and older, with a median age of 59 (20-87) years, including 41 patients (48.2%) aged ≥60 years. The ratio of male to female was 1∶1.36. Overall, 77.6% of the patients were diagnosed with Ann Arbor stage Ⅲ-Ⅳ, and 17 cases (20.0%) were accompanied by B symptoms. Bone marrow involvement was the most common (34.1%). ②Overall, 71 patients received immunochemotherapy. The overall response rate was 86.6%, and the complete recovery rate was 47.1% of 68 evaluated patients. Disease progression or relapse in the first 2 years was observed in 23.9% of the patient. Overall, 14.1% of the patients died during follow-up. ③Of the 56 patients receiving R-CHOP-like therapies, the 3-year and 5-year progression-free survival (PFS) rates were 85.2% and 72.8%, respectively, and the 3-year and 5-year overall survival (OS) rates were 95.9% and 88.8%, respectively. The univariate analysis showed that age ≥60 years old ( HR=3.430, 95% CI 1.256-9.371, P=0.016), B symptoms ( HR=5.030, 95% CI 1.903-13.294, P=0.016), Prognostic Nutritional Index (PNI) <45.25 ( HR=3.478, 95% CI 1.299-9.310, P=0.013), Follicular Lymphoma International Prognostic Index (FLIPI) high-risk ( HR=2.918, 95% CI 1.074-7.928, P=0.036), and PRIMA-prognostic index (PRIMA-PI) high-risk ( HR=2.745, 95% CI 1.057-7.129, P=0.038) significantly predicted PFS. Moreover, age ≥60 years old and B symptoms were independent risk factors for PFS. Progression of disease within 24 months (POD24) significantly predicted OS in the univariate analysis. Conclusions:FL is more common among middle-aged and older women. Age, B symptoms, PNI score, FLIPI high-risk, PRIMA-PI high-risk, and POD24 influenced PFS and OS. The CGA can be used for treatment selection and risk prognostication in older patients with FL.

Objective To investigate the relationship between single nucleotide polymorphisms(SNPs)in the eNOS gene and genetic susceptibility to systemic lupus erythematosus(SLE)in Hainan.Methods Blood samples were collected from SLE patients(SLE group,n=214)and healthy controls(control group,n=214)from January 2020 to December 2022 at the First Affiliated Hospital of Hainan Medical College and Hainan Provincial People's Hospital.The bases of eNOS gene rs3918188,rs1799983 and rs1007311 loci in each group were detected by SNaPshot sequencing technology.Logistic regression was used to analyze the correlation between genotypes,alleles and gene models(dominant model,recessive model,and overdominant model)of the above 3 target loci of the eNOS gene and genetic susceptibility to SLE.Haplotype analysis was conducted using HaploView 4.2 software to investigate the relationship between haploid and genetic susceptibility to SLE at each site.Results The results of logistic regression analysis revealed that the CC genotype and the C allele at rs3918188 locus were risk factors for genetic susceptibility to SLE(CC vs.AA:OR=2.449,P<0.05;C vs.A:OR=2.133,P<0.001).In recessive model at rs3918188 locus,CC genotype carriers had an increased risk of SLE development compared with AA+AC genotype carriers(OR=2.774,P<0.001).In contrast,in overdominant model at this locus,AC genotype carriers had a decreased risk of SLE occurrence compared with AA+CC genotype carriers(OR=0.385,P<0.001).In addition,polymorphisms of rs1799983 and rs1007311 were not associated with susceptibility to SLE in genotype,allele type and the 3 genetic models(P>0.05).Haplotype analysis revealed a strong linkage disequilibrium between the rs1007311 and rs1799983 loci of the eNOS gene,but no significant correlation was found between haplotype and genetic susceptibility to SLE(P>0.05).Conclusion The CC genotype and C allele at rs3918188 locus of eNOS gene may be risk factors for SLE in Hainan,while the risk of SLE occurrence is reduced in carriers of AC genotype under the overdominant model.

Objective To investigate the effect of enhanced three-dimensional variable reversal angle fast spin-echo single breath-hold magnetic resonance cholangiopancreatography(3D SPACE BH MRCP)with high parallel acquisition factor on image quality.Methods A total of 33 patients with clinically suspected pancreatobiliary duct disease who underwent epigastric enhancement and magnetic resonance cholangiopancreatography(MRCP)examination were prospectively collected.All patients were required to acquire a single 3D SPACE BH MRCP before and after enhancement.The signal intensity of the common bile duct and background,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective scores of 3D SPACE BH MRCP before and after enhancement were recor-ded.Statistical analyses were performed using the Wilcoxon signed-rank sum test,and the Kappa test was used to assess the consis-tency of scores between the two readers.Results The difference in the common bile duct signals of 3D SPACE BH MRCP before and after enhancement was not statistically significant(Z=-1.215,P=0.224),however the background signal was decreased after enhancement with a significant difference(Z=-3.878,P＜0.001).The SNR and CNR of the images were better than those of 3D SPACE BH MRCP before enhancement(Z=-4.458,P＜0.001;Z=-4.583,P＜0.001).The subjective score of 3D SPACE BH MRCP after enhancement was better than that before enhancement,and the difference was statistically significant(Z=-2.646,P=0.008).There was a strong inter-reader agreement before and after enhancement 3D SPACE BH MRCP scores(Kappa=0.70,P＜0.01 and Kappa=0.73,P＜0.01).Conclusion The enhanced 3D SPACE BH MRCP between portal vein phase and equilibrium phase dose not affect the display of pancreaticobiliary duct,and can effectively suppress the background signal and improve the image quality of MRCP.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective To explore the efficiency of artificial intelligence and radiomics-assisted X-ray in diagnosis of lumbar osteoporotic vertebral compression fractures(OVCF).Methods The clinical data of 455 patients diagnosed as lumbar OVCF by MRI in our hospital were selected.The patients were divided into the training group(n=364)and the validation group(n=91),X-ray films were extracted,the image delineation,feature extraction and data analysis were carried out,and the artificial intelligence radiomics deep learning was applied to establish a diagnostic model for OVCF.After verifying the effectiveness of the model by receiver operating characteristic(ROC)curve,area under the curve(AUC),calibration curve,and decision curve analysis(DCA),the efficiencies of manual reading,model reading,and model-assisted manual reading of X-ray in the early diagnosis of OVCF were compared.Results The ROC curve,AUC and calibration curve proved that the model had good discrimination and calibration,and excellent diagnostic performance.DCA demonstrated that the model had a higher clinical net benefit.The diagnostic efficiency of the manual reading group:the accuracy rate was 0.89,the recall rate was 0.62.The diagnostic efficiency of the model reading group:the accuracy rate was 0.93,the recall rate was 0.86,the model diagnosis showed good predictive performance,which was significantly better than the manual reading group.The diagnostic efficiency of the model-assisted manual reading group:the accuracy rate was 0.92,the recall rate was 0.72,and the recall rate of the model-assisted manual reading group was higher than that of the manual reading group,but lower than that of the model reading group,indicating the superiority of the model diagnosis.Conclusion The diagnostic model established based on artificial intelligence and radiomics in this study has reached an ideal level of efficacy,with better diagnostic efficacy compared with manual reading,and can be used to assist X-ray in the early diagnosis of OVCF.

Objective To develop a clinical prediction model for predicting risk factors for prolonged hospital stay after anterior cervical discectomy and fusion(ACDF).Methods The clinical data of 914 patients underwent ACDF treatment for cervical spondylotic myelopathy(CSM)were retrospectively analyzed.According to the screening criteria,800 eligible patients were eventually included,and the patients were divided into the development cohort(n=560)and the validation cohort(n=240).LASSO regression was used to screen variables,and multivariate Logistic regression analysis was used to establish a prediction model.The prediction model was evaluated from three aspects:differentiation,calibration and clinical effectiveness.The performance of the model was evaluated by area under the curve(AUC)and Hosmer-Lemeshow test.Decision curve analysis(DCA)was used to evaluate the clinical effectiveness of the model.Results In this study,the five factors that were significantly associated with prolonged hospital stay were male,abnormal BMI,mild-to-moderate anemia,stage of surgery(morning,afternoon,evening),and alcohol consumption history.The AUC of the development cohort was 0.778(95%CI:0.740 to 0.816),with a cutoff value of 0.337,and that of the validation cohort was 0.748(95%CI:0.687 to 0.809),with a cutoff value of 0.169,indicating that the prediction model had good differentiation.At the same time,the Hosmer-Lemeshow test showed that the model had a good calibration degree,and the DCA proved that it was effective in clinical application.Conclusion The prediction model established in this study has excellent comprehensive performance,which can better predict the risk of prolonged hospital stay,and can guide clinical intervention as soon as possible,so as to minimize the postoperative hospital stay and reduce the cost of hospitalization.