Brain abscess from oral microbiota approached by metagenomic next-generation sequencing: A case report and review of literature

BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness of pathogens needs to be improved.CASE SUMMARY We report the case of a 54-year-old male with a brain abscess caused by oral bacteria.The patient recovered well after receiving a combination of metagenomic next-generation sequencing(mNGS)-assisted guided medication and surgery.CONCLUSION Therefore,mNGS may be widely applied to identify the pathogenic microor-ganisms of brain abscesses and guide precision medicine.

成纤维细胞生长因子-23与慢性肾脏病患者矿物质代谢紊乱的相关性研究

目的观察慢性肾脏病(CKD)非透析患者的血清钙、磷、全段甲状旁腺激素(iPTH)、25-羟维生素D、成纤维细胞生长因子-23(FGF-23)水平,以及肱踝脉搏波传导速度(baPWV),并探讨FGF-23与上述指标的相关性。方法选取河北省人民医院35例健康者(对照组)、34例CKD 1期、35例CKD 2期、34例CKD 3a期、33例CKD 3b期、38例CKD 4期和32例CKD 5期患者。检测各组患者的血压、体重指数(BMI)、血清白蛋白、肌酐、钙、磷、25-羟维生素D、iPTH、FGF23水平及baPWV。结果对照组及CKD各期患者的年龄、性别构成及BMI无差异(P>0.05)。与对照组比较,CKD 3a^5期组和CKD 2~5期组患者的收缩压和舒张压升高(P<0.05);CKD各期患者的24 h尿白蛋白定量升高(P<0.05),CKD 3a^5期组患者的血肌酐、血磷、iPTH水平升高,血清白蛋白、血钙水平下降(P<0.05);CKD 2~5期组患者的25-羟维生素D水平下降,CKD 3a^5期组患者的FGF-23水平升高(P<0.05);7组不同水平25-羟维生素D例数所占比例比较有差异(P<0.05);与对照组及CKD 1期组分别比较,CKD 3a^5期组患者的baPWV加快(P<0.05);所有CKD患者中血清FGF-23与血钙(r=-0.175,P=0.000)、25-羟维生素D(r=-0.130,P=0.000)呈负相关,与血磷(r=0.236,P=0.000)、iPTH(r=0.249,P=0.000)呈正相关。结论CKD患者血清iPTH、FGF-23水平的变化先于血钙、磷的变化。随着eGFR的降低,25-羟维生素D的下降时间早于iPTH和FGF-23水平的升高。在CKD的早期即出现血管僵硬度增加。