The clinical characters, diagnosis and differential diagnosis of paroxysmal kinesigenic choreoathetosis （PKC）, and efficacy of the anti-epileptic drugs （AEDs） were investigated. Thirty-one patients with PKC were c...The clinical characters, diagnosis and differential diagnosis of paroxysmal kinesigenic choreoathetosis （PKC）, and efficacy of the anti-epileptic drugs （AEDs） were investigated. Thirty-one patients with PKC were collected, and the clinical characters and change of EEG were analyzed. The average age of the first attack was 16.8 years old and the pinnacle was 10 to 20 years old. There were definite causes for every attack and the sudden the whole attack was always less than 1 min. movement was the most common one （92%）. Time for The attack presented with muscle tension disturbance （83.9%）, movement like dancing （16.1%）, abnormal movement of mouth and face and other symptoms （16.2%）. The attack tended to be very frequent and 71% patients were beyond once per day. The EEG examination and image scan of primary PKC were normal in most patients. Low dosage of AEDs could control the attack of 50%-77.3% patients. It was concluded that PKC was a common disease of movement disorder. The therapy by AEDs was very effective. PKC should be differentiated from epilepsy and the relationship between PKC and epilepsy needs further research.展开更多
The class 1 integron and complex gene cassettes among different species of clinical isolates in northern China were characterized in this study. 383 clinical isolates were obtained from northern China, and class 1 int...The class 1 integron and complex gene cassettes among different species of clinical isolates in northern China were characterized in this study. 383 clinical isolates were obtained from northern China, and class 1 integrons containing gene cassettes widely distributed among gram negative clinical isolates was observed. We find that the class 1 integron showed positive correlation with multidrug resistance phenotype of gram negative bacteria. In addition, we find that isolates belonged to one species harbored different types of gene cassette arrays, while same types of gene cassette arrays were observed in different species of isolates. The diversity of gene cassette arrays among the isolates indicated the complexity of multidrug resistance in clinical isolates in northern China.展开更多
Objective: We summarize the clinical and follow-up data of twenty-one children with neonatal diabetes mellitus (NDM) to strengthen the understanding of NDM and provide reference for clinical diagnosis and follow-up. M...Objective: We summarize the clinical and follow-up data of twenty-one children with neonatal diabetes mellitus (NDM) to strengthen the understanding of NDM and provide reference for clinical diagnosis and follow-up. Methods The clinical characteristics, growth and development of twenty-one children with NDM who were diagnosed and treated in the Children's Hospital of Nanjing Medical University from January 2011 to August 2018 were retrospectively analyzed. Results The median age of diagnosis was 97 days and the follow-up period was 0.96 to 47.6 months years. At the time of new diagnosis, 7 cases were complicated with diabetic ketoacidosis and 3 cases with diabetic ketoacidosis. Seven patients had diabetic ketoacidosis (DKA) and three patients had diabetic ketosis (DK). Three cases were unclassified because of short follow-up time. Two patients are Transient neonatal diabetes mellitus (TNDM). Sixteen cases are Permanent neonatal diabetes mellitus (PNDM). Thirteen patients underwent drug-experiential treatment with a success rate of 53.8%. Twelve patients had growth and development disorders or language and motor retardation. Eleven cases were improved by genetic testing and the positive rate of gene mutation was 81.8%. There was no significant difference in treatment regimen, complications, genotype and other factors among different growth and development conditions (P > 0.05). Fisher exact probability analysis of growth and development in different treatment schemes showed that there was no significant difference (P>0.05). Conclusions Patients with KCNJ11 and ABCC8 gene mutations often have developmental disorders and sulfonylurea drugs are effective, which can improve the outcome of developmental disorders. There was no correlation between age, complications, genotype and the outcome of growth. When conditions permit, we should perfect gene detection as soon as possible to identify the type of mutation, guiding treatment and judging prognosis.展开更多
目的分析频发急性加重慢性阻塞性肺疾病(COPD)表型患者的临床特征。方法收集2016年01月至2017年01月在上海交通大学医学院附属新华医院崇明分院呼吸科住院被诊断为AECOPD患者136例,综合急性加重频率,将AECOPD患者分为频发急性加重型(57...目的分析频发急性加重慢性阻塞性肺疾病(COPD)表型患者的临床特征。方法收集2016年01月至2017年01月在上海交通大学医学院附属新华医院崇明分院呼吸科住院被诊断为AECOPD患者136例,综合急性加重频率,将AECOPD患者分为频发急性加重型(57例),非频发急性加重型(79例)两组,对两组患者的基线资料、肺功能、炎症指标及共患病进行分析比较。结果 COPD评估测试(CAT评分)频发组患者两次入院前稳定期均明显高于非频发组(13.3±4.1 vs 11.4±2.7,P<0.01;13.1±4.3 vs 11.4±2.7,P<0.01);且频发组患者两次住院好转后肺功能检查,其中FEV1值均明显降低(0.85±0.34Lvs 1.00±0.39L,P<0.05;0.83±0.38Lvs 1.00±0.39L,P<0.05),肺功能处于III/IV级患者比例也明显高于非频发组(均P<0.05)。血气分析发现,与非频发组患者相比,频发组患者两次住院动脉血PH、Pa O2均明显降低,且PCO2均升高,差异均有统计学意义(均P<0.05)。频发组患者两次住院白细胞计数均明显高于非频发组(9.7±3.41×109/L vs 8.5±3.36×109/L,P<0.05;10.2±3.18×109/L vs 8.5±3.36×109/L,P<0.05),同时频发组两次入院时CRP明显高于非频发组(68.21±7.38mg/L vs 48.23±5.16mg/L,P<0.05;70.77±7.63mg/L vs48.23±5.16mg/L,P<0.05),频发组两次入院时PCT明显高于非频发组(0.42±0.046 ng/m L vs 0.26±0.030ng/m L,P<0.05;0.48±0.054 ng/m L vs 0.26±0.030ng/m L,P<0.05)。两组在共患病种类上无明显区别,均主要为冠心病、高血压、糖尿病等疾病。结论频发急性加重的COPD患者CAT评分,肺功能较非频发型患者差,白细胞计数、CRP、PCT值高于非频发型组,共患病种类相近。展开更多
基金supported by a grant from National Natu-ral Sciences Foundation of China (No. 30770752).
文摘The clinical characters, diagnosis and differential diagnosis of paroxysmal kinesigenic choreoathetosis （PKC）, and efficacy of the anti-epileptic drugs （AEDs） were investigated. Thirty-one patients with PKC were collected, and the clinical characters and change of EEG were analyzed. The average age of the first attack was 16.8 years old and the pinnacle was 10 to 20 years old. There were definite causes for every attack and the sudden the whole attack was always less than 1 min. movement was the most common one （92%）. Time for The attack presented with muscle tension disturbance （83.9%）, movement like dancing （16.1%）, abnormal movement of mouth and face and other symptoms （16.2%）. The attack tended to be very frequent and 71% patients were beyond once per day. The EEG examination and image scan of primary PKC were normal in most patients. Low dosage of AEDs could control the attack of 50%-77.3% patients. It was concluded that PKC was a common disease of movement disorder. The therapy by AEDs was very effective. PKC should be differentiated from epilepsy and the relationship between PKC and epilepsy needs further research.
基金supported by Twelfth Five-Year Mega Project of Research on The Prevention and Control of HIV/AIDS,Viral Hepatitis Infectious Diseases 2013ZX10004-217 from the Ministry of Science and Technology,People’s Republic of China,the Project Sponsored by the Young Scholar Scientific Research Foundation of China CDC(No.2013A101)General Program of State Key Laboratory for Infections Disease Prevention and Control(No.2012SKLID205)
文摘The class 1 integron and complex gene cassettes among different species of clinical isolates in northern China were characterized in this study. 383 clinical isolates were obtained from northern China, and class 1 integrons containing gene cassettes widely distributed among gram negative clinical isolates was observed. We find that the class 1 integron showed positive correlation with multidrug resistance phenotype of gram negative bacteria. In addition, we find that isolates belonged to one species harbored different types of gene cassette arrays, while same types of gene cassette arrays were observed in different species of isolates. The diversity of gene cassette arrays among the isolates indicated the complexity of multidrug resistance in clinical isolates in northern China.
基金Key projects for the development of medical science and technology in Nanjing (201823014)
文摘Objective: We summarize the clinical and follow-up data of twenty-one children with neonatal diabetes mellitus (NDM) to strengthen the understanding of NDM and provide reference for clinical diagnosis and follow-up. Methods The clinical characteristics, growth and development of twenty-one children with NDM who were diagnosed and treated in the Children's Hospital of Nanjing Medical University from January 2011 to August 2018 were retrospectively analyzed. Results The median age of diagnosis was 97 days and the follow-up period was 0.96 to 47.6 months years. At the time of new diagnosis, 7 cases were complicated with diabetic ketoacidosis and 3 cases with diabetic ketoacidosis. Seven patients had diabetic ketoacidosis (DKA) and three patients had diabetic ketosis (DK). Three cases were unclassified because of short follow-up time. Two patients are Transient neonatal diabetes mellitus (TNDM). Sixteen cases are Permanent neonatal diabetes mellitus (PNDM). Thirteen patients underwent drug-experiential treatment with a success rate of 53.8%. Twelve patients had growth and development disorders or language and motor retardation. Eleven cases were improved by genetic testing and the positive rate of gene mutation was 81.8%. There was no significant difference in treatment regimen, complications, genotype and other factors among different growth and development conditions (P > 0.05). Fisher exact probability analysis of growth and development in different treatment schemes showed that there was no significant difference (P>0.05). Conclusions Patients with KCNJ11 and ABCC8 gene mutations often have developmental disorders and sulfonylurea drugs are effective, which can improve the outcome of developmental disorders. There was no correlation between age, complications, genotype and the outcome of growth. When conditions permit, we should perfect gene detection as soon as possible to identify the type of mutation, guiding treatment and judging prognosis.
文摘目的分析频发急性加重慢性阻塞性肺疾病(COPD)表型患者的临床特征。方法收集2016年01月至2017年01月在上海交通大学医学院附属新华医院崇明分院呼吸科住院被诊断为AECOPD患者136例,综合急性加重频率,将AECOPD患者分为频发急性加重型(57例),非频发急性加重型(79例)两组,对两组患者的基线资料、肺功能、炎症指标及共患病进行分析比较。结果 COPD评估测试(CAT评分)频发组患者两次入院前稳定期均明显高于非频发组(13.3±4.1 vs 11.4±2.7,P<0.01;13.1±4.3 vs 11.4±2.7,P<0.01);且频发组患者两次住院好转后肺功能检查,其中FEV1值均明显降低(0.85±0.34Lvs 1.00±0.39L,P<0.05;0.83±0.38Lvs 1.00±0.39L,P<0.05),肺功能处于III/IV级患者比例也明显高于非频发组(均P<0.05)。血气分析发现,与非频发组患者相比,频发组患者两次住院动脉血PH、Pa O2均明显降低,且PCO2均升高,差异均有统计学意义(均P<0.05)。频发组患者两次住院白细胞计数均明显高于非频发组(9.7±3.41×109/L vs 8.5±3.36×109/L,P<0.05;10.2±3.18×109/L vs 8.5±3.36×109/L,P<0.05),同时频发组两次入院时CRP明显高于非频发组(68.21±7.38mg/L vs 48.23±5.16mg/L,P<0.05;70.77±7.63mg/L vs48.23±5.16mg/L,P<0.05),频发组两次入院时PCT明显高于非频发组(0.42±0.046 ng/m L vs 0.26±0.030ng/m L,P<0.05;0.48±0.054 ng/m L vs 0.26±0.030ng/m L,P<0.05)。两组在共患病种类上无明显区别,均主要为冠心病、高血压、糖尿病等疾病。结论频发急性加重的COPD患者CAT评分,肺功能较非频发型患者差,白细胞计数、CRP、PCT值高于非频发型组,共患病种类相近。
