Ultrasonic manifestations and age distribution of internal abdominal hernia in children

Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively analyzed.The ultrasonic findings were observed,and the age distribution of children was analyzed.Results Among 53 cases,"cross sign"was observed in 22 cases(22/53,41.51%),and"hernia ring beak sign"was detected in 26 cases(26/53,49.06%)by preoperative ultrasound,according to which 21 cases were diagnosed as internal abdominal hernia,with the accuracy of 39.62%(21/53).Meanwhile,manifestations of intestinal obstruction were noticed in 48 cases(48/53,90.57%),and intestinal necrosis was considered in 22 cases(22/53,41.51%).Four cases were misdiagnosed as intestinal perforation,appendicitis,intestinal atresia and volvulus,each in 1 case.The onset age of postoperative adhesive band internal hernia was larger than that of mesenteric hiatal hernia(P<0.05),while no significant difference of onset age was found among other types of internal abdominal hernias(all P>0.05).Intestinal ischemic necrosis was found in 25 cases,while the incidence of intestinal necrosis in children aged≤1 year,>1 and≤3 years,>3 and≤7 years and those>7 years was 66.67%(12/18),33.33%(4/12),36.36%(4/11)and 41.67%(5/12),respectively.Conclusion The characteristic ultrasonic findings of internal abdominal hernia in children included"cross sign"and"hernia ring beak sign".Internal abdominal hernia in children under 1 year had high risk of intestinal necrosis.

Correlation Between the Clinical Severity, Bacterial Load, and Inflammatory Reaction in Children with Mycoplasma Pneumoniae Pneumonia

Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagnostic method.This study was performed to explore the relationship between the qPCR findings,clinical symptoms,and inflammatory markers in children with MPP.Four hundred children with MPP have been enrolled in this retrospective analysis.All clinical and analytical information,including mycoplasma pneumoniae(MP)PCR results,has been collected.Based on the PCR results,the patients were divided into groups with load values(copy number)<105(54 cases),2105 and<106(71 cases),2106 and<107(112 cases),>107 and<108(114 cases),and>108(49 cases).The clinical features(including symptoms and signs)and inflammatory indicators were compared among the groups.The incidence of high fever(above 39℃),thermal peak during the entire hospitalization period,fever duration,days of hospitalization,and plasma lactate dehydrogenase(LDH)levels were statistically correlated with the MP PCR load value in children with MPP.The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization>duration of fever>period of hospitalization>LDH value>C-reactive protein value.The host immune response was significantly greater in the complication group than in the non-complication group.

SIL1 improves cognitive impairment in APP23/PS45 mice by regulating amyloid precursor protein processing and Aβ generation

SIL1,an endoplasmic reticulum(ER)-resident protein,is reported to play a protective role in Alzheimer’s disease(AD).However,the effect of SIL1 on amyloid precursor protein(APP)processing remains unclear.In this study,the role of SIL1 in APP processing was explored both in vitro and in vivo.In the in vitro experiment,SIL1 was either overexpressed or knocked down in cells stably expressing the human Swedish mutant APP695.In the in vivo experiment,AAV-SIL1-EGFP or AAV-EGFP was microinjected into APP23/PS45 mice and their wild-type littermates.Western blotting(WB),immunohistochemistry,RNA sequencing(RNA-seq),and behavioral experiments were performed to evaluate the relevant parameters.Results indicated that SIL1 expression decreased in APP23/PS45 mice.Overexpression of SIL1 significantly decreased the protein levels of APP,presenilin-1(PS1),and C-terminal fragments(CTFs)of APP in vivo and in vitro.Conversely,knockdown of SIL1 increased the protein levels of APP,β-site APP cleavage enzyme 1(BACE1),PS1,and CTFs,as well as APP mRNA expression in 2EB2 cells.Furthermore,SIL1 overexpression reduced the number of senile plaques in APP23/PS45 mice.Importantly,Y-maze and Morris Water maze tests demonstrated that SIL1 overexpression improved cognitive impairment in APP23/PS45 mice.These findings indicate that SIL1 improves cognitive impairment in APP23/PS45 mice by inhibiting APP amyloidogenic processing and suggest that SIL1 is a potential therapeutic target for AD by modulating APP processing.

Effects of Standing Time during Pretreatment on the Nitrite Concentration Detected by Spectrophotometric Method

Food safety problems caused by excessive nitrite addition have been frequently reported and the detection of nitrite in food is particularly important. The standing time during the pretreatment of primary sample has a great influence on the concentration of nitrite tested by spectrophotometric method. In this context, three kinds of food samples are prepared, including canned mustard, canned fish and home-made pickled water. A series of standing times are placed during the sample pretreatments and the corresponding nitrite contents in these samples are detected by spectrophotometric method based on N-ethylenediamine dihydrochloride. This study aims to find out a reasonable standing time during the pretreatment of food sample, providing influence factor for precise detection of nitrite.

Comparison of acute pneumonia caused by SARS-CoV-2 and other respiratory viruses in children:a retrospective multi-center cohort study during COVID-19 outbreak

Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.

Scopolamine causes delirium-like brain network dysfunction and reversible cognitive impairment without neuronal loss

Delirium is a severe acute neuropsychiatric syndrome that commonly occurs in the elderly and is considered an independent risk factor for later dementia.However,given its inherent complexity,few animal models of delirium have been established and the mechanism underlying the onset of delirium remains elusive.Here,we conducted a comparison of three mouse models of delirium induced by clinically relevant risk factors,including anesthesia with surgery(AS),systemic inflammation,and neurotransmission modulation.We found that both bacterial lipopolysaccharide(LPS)and cholinergic receptor antagonist scopolamine(Scop)induction reduced neuronal activities in the delirium-related brain network,with the latter presenting a similar pattern of reduction as found in delirium patients.Consistently,Scop injection resulted in reversible cognitive impairment with hyperactive behavior.No loss of cholinergic neurons was found with treatment,but hippocampal synaptic functions were affected.These findings provide further clues regarding the mechanism underlying delirium onset and demonstrate the successful application of the Scop injection model in mimicking delirium-like phenotypes in mice.

COSINE:A web server for clonal and subclonal structure inference and evolution in cancer genomics

Cancer cell genomes originate from single-cell mutation with sequential clonal and subclonal expansion of somatic mutation acquisition during pathogenesis,thus exhibiting a Darwinian evolutionary process(Gerstung et al.,2020;Nik-Zainal et al.,2012).Through next-generation sequencing of tumor tissue,this evolutionary process can be characterized by statistical modelling,which can identify the clonal state,somatic mutation order,and evolutionary process(Gerstung et al.,2020;Mcgranahan&Swanton,2017).Inference of clonal and subclonal structure from bulk or single-cell tumor genomic sequencing data has a huge impact on studying cancer evolution.Clonal state and mutation order can provide detailed insight into tumor origin and future development.In the past decade,various methods for subclonal reconstruction using bulk tumor sequencing data have been developed.However,these methods had different programming languages and data input formats,which limited their use and comparison.Therefore,we established a web server for Clonal and Subclonal Structure Inference and Evolution(COSINE)of cancer genomic data,which incorporated twelve popular subclonal reconstruction methods.We deconstructed each method to provide a detailed workflow of single processing steps with a user-friendly interface.To the best of our knowledge,this is the first web server providing online subclonal inference based on the integration of most popular subclonal reconstruction methods.COSINE is freely accessible at www.clab-cosine.net.

The roles of RACK1 in the pathogenesis of Alzheimer's disease

The receptor for activated C kinase 1(RACK1)is a protein that plays a crucial role in various signaling pathways and is involved in the pathogenesis of Alzheimer's disease(AD),a prevalent neurodegenerative disease.RACK1 is highly expressed in neuronal cells of the central nervous system and regulates the pathogenesis of AD.Specifically,RACK1 is involved in regulation of the amyloid-β precursor protein processing through α-or β-secretase by binding to different protein kinase C isoforms.Additionally,RACK1 promotes synaptogenesis and synaptic plasticity by inhibiting N-methyl-D-aspartate receptors and activating gamma-aminobutyric acid A receptors,thereby preventing neuronal excitotoxicity.RACK1 also assembles inflammasomes that are involved in various neuroinflammatory pathways,such as nuclear factor-kappa B,tumor necrosis factor-alpha,and NOD-like receptor family pyrin domain-containing 3 pathways.The potential to design therapeutics that block amyloid-β accumulation and inflammation or precisely regulate synaptic plasticity represents an attractive therapeutic strategy,in which RACK1 is a potential target.In this review,we summarize the contribution of RACK1 to the pathogenesis of AD and its potential as a therapeutic target.

Changes on Stroke Burden Attributable to Ambient Fine Particulate Matter in China

Objective In recent decades,China has implemented a series of policies to address air pollution.We aimed to assess the health effects of these policies on stroke burden attributable to ambient fine particulate matter(PM_(2.5)).Methods Joinpoint regression was applied to explore the temporal tendency of stroke burden based on data from the Global Burden of Disease 2019 study.Results The age-standardized rates of disability-adjusted life year(DALY)for stroke attributable to ambient PM2.5 in China,increased dramatically during 1990-2012,subsequently decreased at an annual percentage change(APC)of-1.98[95% confidence interval(CI):-2.26,-1.71]during 2012-2019.For ischemic stroke(IS),the age-standardized DALY rates doubled from 1990 to 2014,and decreased at an APC of-0.83(95%CI:-1.33,-0.33)during 2014-2019.Intracerebral hemorrhage(ICH)showed a substantial increase in age-standardized DALY rates from 1990 to 2003,followed by declining trends,with APCs of-1.46(95%CI:-2.74,-0.16)during 2003-2007 and-3.33(95%CI:-3.61,-3.06)during 2011-2019,respectively.Conversely,the age-standardized DALY rates for subarachnoid hemorrhage(SAH)generally declined during 1990-2019.Conclusion Our results clarified the dynamic changes of the ambient PM_(2.5)-attributable stroke burden in China during 1990-2019,highlighting the health effects of air quality improvement policies.

Non-invasive estimation of pulmonary hypertension and clinical deterioration risk in pediatric congenital heart disease:Development and validation of predictive tools

To the Editor:Owing to the heterogeneity of congenital heart disease-associated pulmonary hypertension(CHDPH)disease and the development of the pulmonary vascular system in pediatric patients,the management of CHD-PH in children is signicantly different from that in adults.[1]Early identication and intervention of CHD-PH are of great signicance for disease management in children with CHD,and non-invasive,accurate clinical tools are urgently needed to predict PH risk in children with CHD.However,the applicability of the current risk-scoring system to pediatric CHD-PH remains unclear.Furthermore,there are presently no user-friendly,non-invasive online tools available for predicting CHD-PH,and there is a scarcity of related studies in Asian populations.This study aimed to develop and validate the prediction tools for estimating the risk of pulmonary hypertension and clinical deterioration in children with congenital heart disease.

Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis:a nationwide retrospective study in China

Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a life-threatening systemic vasculitis featured by liability to renal involvement.However,there are few studies on the risk factors and predictive models for renal outcomes of AAV in children.Methods Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively.The risk factors and predictive model of end-stage renal disease(ESRD)in AAV were explored.Results Renal involvement was the most typical manifestation(95.5%),and the crescent was the predominant pathological lesion(84.9%).The estimated glomerular filtration rate(eGFR)was evaluated in 114 patients,of whom 59.6%developed ESRD,and the median time to ESRD was 3.20 months.The eGFR[P=0.006,odds ratio(OR)=0.955,95%confidence interval(CI)=0.924–0.987]and the percentages of global glomerulosclerosis(pGGS;P=0.018,OR=1.060,95%CI=1.010–1.112)were independent risk factors for ESRD of renal biopsy.Based on the pGGS and eGFR at renal biopsy,we developed three risk grades of ESRD and one predictive model.The Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades(P<0.001).Compared with serum creatinine at baseline,the predictive model had higher accuracy(0.86 versus 0.58,P<0.001)and a lower coefficient of variation(0.07 versus 0.92)in external validation.Conclusions Renal involvement is the most common manifestation of pediatric AAV in China,of which more than half deteriorates into ESRD.The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children.

Development of the Scientific,Transparent and Applicable Rankings (STAR) tool for clinical practice guidelines

Background:This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines,named Scientific,Transparent and Applicable Rankings tool(STAR),and test its reliability,validity,and usability.Methods:This study set up a multidisciplinary working group including guideline methodologists,statisticians,journal editors,clinicians,and other experts.Scoping review,Delphi methods,and hierarchical analysis were used to develop the STAR tool.We evaluated the instrument’s intrinsic and interrater reliability,content and criterion validity,and usability.Results:STAR contained 39 items grouped into 11 domains.The mean intrinsic reliability of the domains,indicated by Cronbach’sαcoefficient,was 0.588(95%confidence interval[CI]:0.414,0.762).Interrater reliability as assessed with Cohen’s kappa coefficient was 0.774(95%CI:0.740,0.807)for methodological evaluators and 0.618(95%CI:0.587,0.648)for clinical evaluators.The overall content validity index was 0.905.Pearson’s r correlation for criterion validity was 0.885(95%CI:0.804,0.932).The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min.Conclusion:The instrument performed well in terms of reliability,validity,and efficiency,and can be used for comprehensively evaluating and ranking guidelines.

Maternal sleep deprivation induces gut microbial dysbiosis and neuroinflammation in offspring rats

Maternal sleep deprivation(MSD)is a global public health problem that affects the physical and mental development of pregnant women and their newborns.The latest research suggests that sleep deprivation(SD)disrupts the gut microbiota,leading to neuroinflammation and psychological disturbances.However,it is unclear whether MSD affects the establishment of gut microbiota and neuroinflammation in the newborns.In the present study,MSD was performed on pregnant SpragueDawley rats in the third trimester of pregnancy(gestational days 15-21),after which intestinal contents and brain tissues were collected from offspring at different postnatal days(P1,P7,P14,and P56).Based on microbial profiling,microbial diversity and richness increased in pregnant rats subjected to MSD,as reflected by the significant increase in the phylum Firmicutes.In addition,microbial dysbiosis marked by abundant Firmicutes bacteria was observed in the MSD offspring.Furthermore,quantitative real-time polymerase chain reaction(q RT-PCR)and enzyme-linked immunosorbent assay(ELISA)showed that the expression levels of proinflammatory cytokines interleukin 1β(IL-1β)and tumor necrosis factorα(TNF-α)were significantly higher in the MSD offspring at adulthood(P56)than in the control group.Through Spearman correlation analysis,IL-1βand TNF-αwere also shown to be positively correlated with Ruminococcus_1 and Ruminococcaceae_UCG-005 at P56,which may determine the microbiota-host interactions in MSDrelated neuroinflammation.Collectively,these results indicate that MSD changes maternal gut microbiota and affects the establishment of neonatal gut microbiota,leading to neuroinflammation in MSD offspring.Therefore,understanding the role of gut microbiota during physiological development may provide potential interventions for cognitive dysfunction in MSD-impacted offspring.

Analysis of the social and clinical factors affecting the age of children when receiving surgery for hypospadias:a retrospective study of 1611 cases in a single center

We aimed to explore the associations between the age at which children undergo surgery for hypospadias and a range of social and clinical factors in a single center.Our aim was to promote the early surgical treatment of children with hypospadias.For a 6-year period,social and clinical data were collected from all children undergoing surgery to repair hypospadias in Children’s Hospital of Chongqing Medical University(Chongqing,China),located in southwest of China.We analyzed the correlations between age at surgery and a range of social and clinical factors.A total of 1611 eligible cases were recruited,with a mean age of 54.3 months and a median age of 42 months:234 cases(14.5%)were classified into a“timely operation”group,419(26.0%)cases into a“subtimely operation”group,and 958(59.5%)cases into a“delayed operation”group.According to multivariate regression analyses,the higher the regional economic level,the closer the urethral opening to the perineum,and the higher the educational level of the guardians was,the younger the children were when they underwent the initial surgery for hypospadias;this was also the case for families without other children.Our subgroup analysis showed that the primary educational level of the guardians was a risk factor for subtimely surgery in their children(odds ratio[OR]=1.52,95%confidence interval[CI]:1.08-2.15,P<0.05).A lower regional economic level(OR=1.87,95%CI:1.26-2.78,P<0.01),a lower educational level of the guardians(OR=3.84,95%CI:2.31-6.41,P<0.01),and an anterior-segment urethral opening(OR_(1)[vs middle hypospadias]=2.07,95%CI:1.42-3.03;0R_(2)[vs posterior hypospadias]=2.63,95%CI:1.75-3.95;P<0.01)were all risk factors for delayed surgery in children.

Effects of policies and containment measures on control of COVID- 19 epidemic in Chongqing

BACKGROUND Coronavirus disease 2019(COVID-19)is an emerging,rapidly evolving disease that spreads through the respiratory system and is highly contagious.In March 2020,the World Health Organization declared the COVID-19 outbreak a pandemic.In China,the pandemic was controlled after 2 mo through effective policies and containment measures.Describing the detailed policies and containment measures used to control the epidemic in Chongqing will provide a reference for the prevention and control of COVID-19 in other areas of the world.AIM To explore the effects of different policies and containment measures on the control of the COVID-19 epidemic in Chongqing.METHODS Epidemiological data on COVID-19 in Chongqing were prospectively collected from January 21 to March 15,2020.The policies and prevention measures implemented by the government during the epidemic period were also collected.Trend analysis was performed to explore the impact of the main policy measures on the effectiveness of the control of COVID-19 in Chongqing.As of March 15,the cumulative incidence of COVID-19 in Chongqing was 1.84/100000(576 cases)and the infection fatality rate was 1.04%(6/576).The spread of COVID-19 was controlled by effective policies that involved establishing a group for directing the COVID-19 epidemic control effort;strengthening guidance and supervision;ensuring the supply of daily necessities and medical supplies and equipment to residents;setting up designated hospitals;implementing legal measures;and enhancing health education.Medical techniques were implemented to improve the recovery rate and control the epidemic.Policies such as“the lockdown of Wuhan”,“initiating a first-level response to major public health emergencies”,and“implementing the closed management of residential communities”significantly curbed the spread of COVID-19.Optimizing the diagnosis process,shortening the diagnosis time,and constructing teams of clinical experts facilitated the provision of“one team of medical experts for each patient”treatment for severe patients,which significantly improved the recovery rate and reduced the infection fatality rate.CONCLUSION The prevention policies and containment measures implemented by the government and medical institutions are highly effective in controlling the spread of the epidemic and increasing the recovery rate of COVID-19 patients.

Association of Meteorological Factors with Labial Adhesions in Children: A 7-year Retrospective Analysis with 9,467 Cases

Labial adhesions (LA)(also called labial agglutination) are defined as partial or complete agglutination of labia minora. The condition commonly occurs in girls during childhood with an estimated prevalence of 0.6%–5%and a peak incidence in the age-group of 13–24 months[1]. Over half of all patients present with symptoms related to urinary outlet obstruction[2].

Anti-nuclear matrix protein 2+ juvenile dermatomyositis with severe skin ulcer and infection: A case report and literature review

BACKGROUND Juvenile dermatomyositis(JDM)is an idiopathic inflammatory myopathy that occurs in childhood.It is characterized by muscle weakness and a characteristic rash.Previous literature reports have rarely described JDM with severe skin ulcers and infections.CASE SUMMARY Herein,we describe a case of a 2-year-old female patient who suffered from JDM,whose myositis-specific autoantibodies were positive for anti-nuclear matrix protein 2 antibody,with progressively worsening skin ulcers and severe infections.The patient was treated with glucocorticoids and various immunosuppressants.Nevertheless,further progression of the disease and the combination of primary disease and severe infection in the later period were fatal.CONCLUSION In children,anti-nuclear matrix protein 2+JDM combined with skin ulcers often indicates severe disease.In such cases,personalized treatment for the primary disease and infection prevention and control are essential.

Relationship between quality of life and adolescent glycolipid metabolism disorder:A cohort study

BACKGROUND The prevalence of glucolipid metabolic disorders(GLMDs)in children and adolescents has a recognized association with cardiovascular diseases and type 2 diabetes mellitus in adulthood.Therefore,it is important to enhance our understanding of the risk factors for GLMD in childhood and adolescence.AIM To explore the relationship between quality of life(QoL)and adolescent GLMD.METHODS This study included 1956 samples in 2019 from a cohort study established in 2014.The QoL scale and glycolipid indexes were collected during follow-up;other covariates of perinatal factors,physical measures,and socioeconomic indicators were collected and adjusted.A generalized linear regression model and logistic regression model were used to analyse the correlation between QoL and GLMD.RESULTS Higher scores of QoL activity opportunity,learning ability and attitude,attitude towards doing homework,and living convenience domains correlated negatively with insulin and homeostasis model assessment insulin resistance(IR)levels.Psychosocial factors,QoL satisfaction factors,and total QoL scores had significant protective effects on insulin and IR levels.Activity opportunity,learning ability and attitude,attitude towards doing homework domains of QoL,psychosocial factor,and total score of QoL correlated positively with high density lipoprotein.In addition,the attitude towards doing homework domain was a protective factor for dyslipidaemia,IR>3,and increased fasting blood glucose;four factors,QoL and total QoL score correlated significantly negatively with IR>3.In subgroup analyses of sex,more domains of QoL correlated with insulin and triglyceride levels,dyslipidaemia,and IR>3 in females.Poor QoL was associated with an increased prevalence of GLMD,and the effect was more pronounced in males than in females.Measures to improve the QoL of adolescents are essential to reduce rates of GLMD.CONCLUSION Our study revealed that QoL scores mainly correlate negatively with the prevalence of GLMD in adolescents of the healthy population.The independent relationship between QoL and GLMD can be illustrated by adjusting for multiple covariates that may be associated with glycaemic index.In addition,among females,more QoL domains are associated with glycaemic index.

Magnetic Resonance Spectroscopy and Prognostic Analysis of Molecular Subtypes of Medulloblastoma

Aim: The aim of this study was to investigate whether magnetic resonance spectrum (MRS) and MR imaging features can be used for non-invasive medulloblastoma subgrouping, and analyse patient characteristics and prognosis of molecular subtypes of medulloblastoma. Material and Methods: 32 patients with medulloblastoma underwent MRI prior to surgical resection, 16 of them underwent MRS. MR imaging features and metabolites measured by MRS were analysed to distinguish molecular subtypes of medulloblastoma. Patient demographics, histopathological types, and prognosis of different molecular subtypes were analysed and compared respectively. Results: MRS and MR imaging features differed from different individuals, but without statistical significance that involves acquiring non-quantitative MR imaging features and NAA/Cr, Cho/Cr, Lip/Cr, Glu and Gln/Cr ratio, to be used to determine molecular subtypes. There was no significant difference of the three molecular subtypes in age, gender and pathological type. The 5-year event-free survival (EFS) of SHH, WNT and non SHH/WNT subtype respectively were 75%, 57.1%, 38.1%, with no significant difference (p = 0.382). 5-year EFS of non SHH/WNT subtype was significantly higher in ≤3 years old group than >3 years old group (p = 0.047). Conclusion: MRS and MR imaging features can’t be used to determine molecular subtypes based on our small sample study. There was no significant difference of the prognosis in the three molecular subtypes. The prognosis of ≤3 years old group of non SHH/WNT subtype is better than >3 years old group.

Neonatal Brain Abscess:Case Report of 12 Cases and Literature Review

Objective:To investigate the etiological characteristics,clinical manifestations,and early identification methods of neonatal brain abscess.Methods:The baseline characteristics,clinical manifestations,and laboratory results of 12 neonatal brain abscess cases were retrospectively analyzed.Results:The clinical manifestations were fever,convulsion,and lethargy.A small number of them had respiratory and circulatory failure.The diagnosis made was based on imaging examination.All 12 cases were confirmed by cranial enhanced computed tomography(CT)or magnetic resonance imaging(MRI).Blood cultures of 9 cases were positive,with Escherichia coli in 6 cases,β-hemolytic Streptococcus in 1 case,methicillin-resistant Staphylococcus aureus in 1 case,and Enterococcus faecium in 1 case.However,only 3 of them had positive cerebrospinal fluid(CSF)cultures.All the 12 neonates were treated with antibiotic therapy upon admission,with only 3 cases treated with surgery.Among them,4 recovered and were discharged,while the remaining 8 discontinued their therapy.Conclusion:Escherichia coli is the most common pathogen of neonatal brain abscess in our study.The clinical manifestations of neonatal brain abscess are atypical,and the prognosis is poor.Respiratory and circulatory failure in children with intracranial infection may indicate the presence of brain abscess.For children with suspected brain abscess,cranial enhanced CT or MRI should be performed as soon as possible to make an early diagnosis.The prevention of brain abscess should be prioritized;neonates with sepsis or meningitis should receive prompt and strong antibiotic therapy in an effort to prevent the development of brain abscess.