ObjectiveTo investigate the epidemic characteristics and influencing factors of acute conjunctivitis caused by human adenovirus（HAdv）in Yantian District of Shenzhen City， Guangdong Province from 2014 to 2022， and to provide evidence for formulating effective prevention and control measures. MethodsDescriptive epidemiology was used to analyze the epidemiological characteristics of acute hemorrhagic conjunctivitis （AHC） cases reported from the Chinese disease prevention and control information system. Etiological characteristics of laboratory-confirmed cases were analyzed， and a case-control study method of test-negative design （TND） was conducted as well. According to the result of HAdv detection， analysis was used to identify the influencing factors of morbidity. ResultsA total of 1 005 AHC cases were reported in Yantian District， Shenzhen City from 2014 to 2022， with an average annual incidence rate of 49.49/10⁵. The incidence rate ranged from 4.67/10⁵ to 117.28/10⁵. The peak incidence occurred from July to October each year， with a male-to-female ratio of 1.42∶1. The median （P₂₅，P₇₅） age of onset was 29（12，40） years. A total of 716 eye swabs were collected for etiological detection from 2014 to 2022. HAdv positive detection rate was 36.45% （263/716）， Cox 24v positive detection rate was 0.28% （2/716）， while EV70 was not detected. The longest viral shedding time in eye swabs was 10 days， with a median of 2 days. The highest HAdv positive detection rate （47.47%） was observed when the sampling-to-onset interval was 4‒5 days， and the difference was statistically significant （P<0.05）， with a trend of first increasing and then decreasing. Multivariate logistic regressing analysis showed that aged 18‒ years， and average temperature higher than 24.90 ℃ 3 days before onset （P<0.05） were the risk factors for acute HAdv conjunctivitis. ConclusionAHC in Yantian District， Shenzhen City showed a low level of prevalence from 2014 to 2022， with HAdv being the predominant pathogen. The peak period of viral shedding occurred on the 4th to 5th day after symptom onset， suggesting the importance of adherence to strict home isolation for infected persons. Aged18‒ years and average temperature increased 3 days before onset are associated with an increased risk of adenoviral conjunctivitis. It is recommended to strengthen personal protection and keep doing a good job of AHC surveillance and early warning， so as to timely prevent the outbreaks of AHC.

Objective To observe the characteristics of infant biliary atresia(BA)missed diagnosis by ultrasound.Methods Data of 72 BA infants missed by ultrasound(false-negative,group A),72 BA infants accurately diagnosed by ultrasound(true-positive,group B)and 72 non BA infants(controls,group C)were retrospectively analyzed.Clinical and ultrasonic features were compared between each 2 groups.Logistic regression analysis was performed to screen the impact factors for diagnosing and missed-diagnosing of BA.Results There were significant differences of total bilirubin,direct bilirubin,gamma glutamyl transpeptidase(GGT)and glutamic-oxaloacetic transaminase(GOT)between group A and C,also of total bilirubin,direct bilirubin and GGT between group B and C(all P＜0.05).Significant differences of the incidences of small gallbladder,gallbladder wall rigidity,poor gallbladder contraction function and fibrous plaques in the hepatic hilum were found between group A and B,of undetected or cystic changes in the gallbladder,gallbladder wall rigidity,poor gallbladder contraction function,fibrous plaques in the hepatic hilum and hepatic hilum cysts were noticed between group A and C(all P＜0.05),as well as of undetected or cystic changes in the gallbladder,small gallbladder,gallbladder wall rigidity,gallbladder wall thickening,poor gallbladder contraction function and fibrous plaques in the hepatic hilum were detected between group B and C(all P＜0.05).There were significant differences of display rate of common bile duct between each 2 groups(all P＜0.05).The lower incidence of fibrous plaques in the hepatic hilum and poor gallbladder contraction function were an impact factors for missed diagnosis of BA(both P＜0.05),while higher GGT,higher incidence of fibrous plaques in the hepatic hilum and poor gallbladder contraction function were all impact factors for diagnosis of BA in group A(all P＜0.05).Conclusion Infant BA missed diagnosis by ultrasound had lower incidence of fibrous plaques in the hepatic hilum and poor gallbladder contractile function.Combining with clinical data was helpful for reducing ultrasonic missed diagnosis of BA in infants.

Objective To evaluate the stability,safety and immune enhancement and anti-tumor effects of Wilms'tumor gene 1(WT1)peptide combined with AddaVaxTM emulsion vaccine for acute myeloid leukemia.Methods The stability of WT1 peptide in the adjuvant vaccine was evaluated using MALDI-TOF-MS time-of-flight mass spectrometry.Female C57BL/6 mice were randomly divided into PBS group,WT1 peptide group,and WT1 peptide+AddaVaxTMemulsion adjuvant vaccine group.The immunization was performed at a dose of 50 μg/mouse for antigen and 50 μg/mouse for adjuvant,with intramuscular injection on days 0,14,and 28.HE staining was used to assess the toxicity of intramuscular vaccination on mouse organ tissues.Cytokine levels were detected by ELISA,and the number of IFN-γ-secreting splenocytes was measured by ELISpot.Flow cytometry was employed to detect the maturation of bone marrow-derived dendritic cells(BMDCs)promoted by the vaccine in vitro and the promotion for lymphocyte activation,and H-2Db WT1 tetramer was utilized to detect the proportion of specific CD8+T cells.After establishing a mouse leukemia tumor model using the C1498-mWT1 stable cell line,the anti-tumor effects of the vaccine for prevention and treatment were evaluated.Results The WT1 peptide stably existed in the vaccine without causing significant organ tissue changes in mice after intramuscular injection.Compared to the mice immunized with WT1 aqueous solution,the mice after intramuscular injection of the WT1 peptide emulsion adjuvant vaccine showed stronger immune responses of Th1 cells,including IFN-γ and TNF-α,as well as Th17 cells of IL-17A(P＜0.05),and the mice had not only promoted number of IFN-γ secreting splenocytes(P＜0.01)but also enhanced maturation of BMDCs,as indicated by an increase in the proportions of CD40+/CD11c+and CD86+CD80+/CD11c+ cells(P＜0.05).Additionally,there were increases in both the proportion of CD4+/CD3+T and CD69+/CD8+T cells(P＜0.05)and the proportion of specific CD8+T cells(P＜0.05).In the anti-tumor effect study using the C1498-mWT1 mouse model,the median survival time of the WT1+AddaVaxTM group was extended by 6 d compared to the WT1 aqueous solution group.At day 50,the survival rate of mice in the WT1+AddaVaxTM group was still 28.5％,while all mice in the other groups had died(P＜0.05).Conclusion The vaccine with the WT1 peptide and AddaVaxTM emulsion adjuvant exhibits good immunological and anti-tumor effects.

Objective:To elucidate the current proficiency level in diagnosing pediatric biliary atresia among Chinese sonographers and to identify contributing factors that may influence their diagnostic capabilities.Methods:A cross-sectional internet-based survey was conducted from November 6, 2021, to December 12, 2021. The online questionnaire was disseminated to a national cohort of sonographers via WeChat groups. The survey encompassed three domains: demographic data of the participants, clinical and ultrasonographic knowledge pertaining to biliary atresia, and the cognitive understanding of biliary atresia. Descriptive statistics were utilized for the evaluation of demographic information and sonographers' clinical and ultrasonographic comprehension concerning biliary atresia. A generalized linear model was employed to ascertain the determinants influencing sonographers' expertise in clinical management and ultrasonographic diagnosis of biliary atresia.Results:A total of 511 valid responses were collated. Approximately 64.77% (331/511) of sonographers indicated a lack of comprehensive understanding of the essential parameters for ultrasonographic diagnosis of biliary atresia. Regression analysis revealed that sonographers affiliated with lower-tier hospitals ( β=-0.344, P=0.002), non-pediatric institutions ( β=-0.747, P=0.004), and those with less than 15 years of professional experience ( β=0.952, P<0.001) exhibited diminished proficiency in diagnosing biliary atresia. Upon encountering suspected cases, a mere 5.48% (28/511) of sonographers expressed complete confidence in their diagnostic capabilities. Lower professional grade ( β=-0.572, P<0.001) and lack of prior experience with suspected cases of biliary atresia ( β=-0.693, P<0.001) contributed to reduced diagnostic self-assurance among sonographers. Regarding the clinical and ultrasonographic intricacies associated with biliary atresia, only 3.33% (17/511) of sonographers had a full understanding of the diagnostic significance of hepatic fibrous plaques on ultrasound for biliary atresia. Conclusion:The study underscores a pervasive inadequacy in the understanding and diagnostic confidence among sonographers in relation to pediatric biliary atresia. Various pragmatic factors, including hospital tier, years of experience, and professional ranking, exert a direct impact on the sonographers' diagnostic acumen. Given these findings, there is an exigent need for targeted educational initiatives to enhance the diagnostic proficiency in biliary atresia among sonographers.

Animals ; Mice ; Spinal Neoplasms/pathology* ; Disease Models, Animal

Objective:To investigate the therapeutic effect of skull drilling and/or grinding combined with artificial dermis and vacuum sealing drainage in repairing scalp defects with skull exposure.Methods:From October 2014 to May 2018, 18 patients with scalp defect and skull exposure were treated in the Department of Burn and Plastic Surgery, the Second Clinical College of North Sichuan Medical College, including 10 males and 8 females, with an average age of 64 years (range, 34-86 years). The patients were divided into two groups: group A (by drilling skull or/and grinding combined with artificial dermis cover and vacuum sealing drainage plus two split thickness skin graft repair) and group B (by drilling skull or/andgrinding combined with artificial dermis cover plus two covering leather grinding stage split thickness skin graft repair), 9 cases in each group. The head wound granulation tissue, postoperative complications, skin graft survival rate and wound healing time were compared between the two groups. Vancouver scar assessment scale (VSS) was used to evaluate the wound healing in the two groups.Results:The time of granulation cultivation in group A and group B was (16.44±1.42) days and (29.11±13.32) days, the difference was statistically significant ( P<0.05); The wound healing time of group A and group B was (26.00±3.32) days and (40.67±14.37) days, the difference was statistically significant ( P<0.05); The postoperative complications of group A and group B were 1 case and 5 cases respectively, the difference was statistically significant ( P<0.05). The skin graft survival rates of group A and group B were (97.11±3.44)% and (95.00±4.74)%, the difference was not statistically significant ( P>0.05); The wound scar VSS scores of group A and group B were (7.67±1.32) points and (8.78±1.99) points, the difference was not statistically significant ( P>0.05). Conclusions:By drilling skull and/or grinding combined with artificial dermis cover and vacuum sealing drainage and two stage split thickness skin graft for repairing scalp defect with skull exposure wound can not only better scalp defect with skull exposure wounds, and reduce the postoperative complications, and significantly accelerate wound healing, but also can effectively improve the quality of wound healing, which is worthy of clinical application.

Objective:To explore the clinical effect of X-N advancement flap in repairing pressure ulcer on the buttock or back.Methods:From June 2018 to June 2019, 20 patients with grade Ⅳ pressure ulcers on the buttock or back were hospitalized and treated in the Department of Traumatology, Burns and Plastic Surgery of Fourth Affiliated Hospital of Guangxi Medical University, including 15 males and 5 females, aged 48-89 years. The area of the patient′s wound was 8 cm×5 cm-15 cm×12 cm after debridement, and all were repaired with the X-N advancement flap designed by the author. The flap was designed according to the direction of skin relaxation on both sides of the wound, and the skin was incised in X-shape and sutured in N-shape. The width and advancement distance of the flap were recorded, and the ratio of the advancement distance to the width of the flap was calculated. The flap survival, complication, and follow-up were observed and recorded.Results:The width of the flap was (5.9±1.2) cm, the advancement distance of the flap was (10.3±2.5) cm, and the ratio of the advancement distance to the width of the flap was 1.8±0.4. All the flaps survived, and none of the flaps had blood flow disorder. Local dehiscence occurred in the flap of one patient 1 week after surgery, which was healed after laying on the floating bed, strengthened care, and wound dressing change. The flap of one patient developed infection 5 days after surgery, which was healed after partial suture removal, smooth drainage, and replacement with sensitive antibiotics. The wounds of the remaining 18 patients were all cured. After 3 months of follow-up, the flaps survived well with good elasticity and texture.Conclusions:The X-N advancement flap can make the skin and soft tissue move forward effectively. It is simple and effective to repair pressure ulcers on the back or buttock of patients with this flap, which is worthy of clinical promotion and application.

With the improvement of people's living standard and changes of their lifestyle, the incidence of coronary artery disease (CAD) has increased quite significantly, which has attracted great concern. Examination methods for CAD are more and more advanced, while the cost of inspection is rising. As a traditional test, the exercise treadmill test (ETT) is convenient, safe, and cheap. ETT can be conducted in almost every hospital as it doesn't need advanced equipments. The values of some new evaluation indexes for diagnosis and prognosis of CAD are reviewed in this article.

Objective To evaluate the efficacy and safety of high-frequency electric dissection for colorectal cysts.Methods The personal information,clinical data,operation methods and postoperative complications of patients who were diagnosed as having colorectal cysts and underwent high-frequency electric dissection in Nanfang hospital and Zhujiang Hospital of Southern Medical University between January 1st,2005 and July 1st,2015 were analysed.All patients enrolled in the study were followed up to obtain their resuits of colonoscopy.Results A total of 63 patients were enrolled into our study,9 lesions located in the ileocecus,17 in the ascending colon,19 in the transverse colon,10 in the descending colon,7 in the sigmoid colon and 1 in the rectum.The maximum diameter of the cysts was 20.2+7.5 mm (5-40 mm).All patients underwent high-frequency electric dissection to remove the cysts completely or part of the cyst wall for drainage.Hemorrhage occurred in only one patient and bleeding stopped after being clipped by Titanium clip.Forty-five patients were followed up and there were no delayed complications or recurrence during a postoperative follow-up of 24.1 + 14.3 months (6-87 months).Conclusion High-frequency electric dissection is a safe and effective procedure for the treatment of colorectal cysts.

Objective To investigate whether there has any difference of gastric and small bowel transit time and completion rates between two capsule endoscopes with different size and weight. Methods Clinical data of patients who had undergone OMOM or MiroCam (smaller and lighter than OMOM) capsule endoscopy were retrospectively studied. Comparison of gastric and small bowel transit time and completion rates were made between the two kinds of capsule endoscopy. Results 1, 448 patients (628 in OMOM group and 820 in MiroCam group) were finally includ-ed. In patients with Crohn's disease or suspected Crohn's disease, gastric transit time of OMOM was significantly longer than that of MiroCam [(53.4 ± 52.6) minutes vs (41.1 ± 47.9) minutes, = 0.022]. In patients with gastroin-testinal bleeding, gastric transit time in OMOM was significantly shorter than that in MiroCam [(42.1 ± 44.8) minutes vs (62.0 ± 78.6) minutes, = 0.016). No significant difference in small bowel transit time or completion rate was found. Conclusions We conclude that the differences of gastric transit time, small bowel transit time and completion rates between the two kinds of capsule endoscopy with different size and weight are not significantly. Whereas, in patients with Crohn's disease or suspected Crohn's disease, gastric transit time of smaller and lighter capsule en-doscopy is shorter in patients with gastrointestinal bleeding, but longer of gastric transit time in smaller and lighter capsule endoscopy.