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OBJECTIVES@#To study the clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy (ANE) in children .@*METHODS@#A retrospective analysis was conducted on the medical data of 12 children with SARS-CoV-2 Omicron variant infection-associated ANE who were admitted to the Pediatric Intensive Care Unit, Qingdao Women and Children's Hospital from December 18 to 29, 2022. The children were divided into two groups based on outcomes: death group (7 cases) and survival group (5 cases). The clinical manifestations and auxiliary examination results were compared between the two groups.@*RESULTS@#The median age of the 12 patients was 30 months, with a male-to-female ratio of 1:1. All patients presented with persistent high fever, with a median highest body temperature of 41℃. The median time from fever onset to seizure or consciousness disturbance was 18 hours. The death group had a higher proportion of neurogenic shock, coagulation dysfunction, as well as elevated lactate, D-dimer, interleukin-6, interleukin--8, and interleukin-10 levels compared to the survival group (P<0.05).@*CONCLUSIONS@#Children with SARS-CoV-2 Omicron variant infection-associated with ANE commonly present with persistent high fever, rapidly progressing disease, and have a high likelihood of developing consciousness disorders and multiorgan dysfunction within a short period. The occurrence of neurogenic shock, coagulation dysfunction, and significantly elevated cytokine levels suggests an increased risk of mortality.
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Humans , Female , Child , Male , Infant , SARS-CoV-2 , Retrospective Studies , COVID-19/complications , Brain Diseases/etiology , Prognosis , Fever , Blood Coagulation DisordersABSTRACT
?AlM: To analyze and study the changes of intraocular pressure ( lOP) , visual field and P-ERG on patients with big cup/disk (C/D) in 24h. ?METHODS: A total of 120 cases ( 240 eyes ) diagnosed with big C/D (C/D>0. 3) were divided into group A (C/D ?RESULTS:There was no significant statistical difference in the 24h average lOP (P>0. 05) among the three groups, while the amplitudes had significant statistical differences (P0. 05);Compared with group A, the MD and the PSD were significantly higher in group B, and the difference was of statistical significance (P0. 05), but there were significant statistical differences in amplitudes (P0. 05); Compared with group A, the P50’s amplitude of group B was significantly lower, and the difference was of statistical significance (P ?CONCLUSlON: When the patients’ C/D is no less than 0. 6, there are obvious changes of 24h lOP, static threshold visual field and P-ERG’s P50 wave. For patients with big C/D, a single lOP examination is far from sufficient, so an in-depth visual function examination should be performed. Meanwhile, it’s feasible to regard C/D 0. 6 as a screening criterion for suspected glaucoma.
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Background The effectiveness of medical tissue adhesive for the reparation of operative incision has been recognized,but its influence to ocular surface microenvironment is not quite clear.Objective This study was to appraise the safety and efficacy of α-cyanoacrylate,a medical issue adhesive,for the reparation of the conjunctival and skin laceration.Methods Twenty healthy New Zealand rabbits were randomly divided into suturing group and medical glue group.Routine ophthalmic examination,the level of tear secretion and breakup time of tear film (BUT) were tested before operation.The upper bulbar conjunctiva of each right eye was cut apart about 1.0 cm after surface anesthesia and the skin of back was incised about 2.5 cm length after local anesthesia.The conjunctival and skin lacerations were adhered with compound medical adhesive in the medical glue group,and continuous suture was done to repair the conjunctival laceration and interrupted suture to the skin laceration with 5-0 chorda serica chirurgicalis in the suture group.The routine ophthalmic examination,level of tear secretion,BUT and the states of wound healing were examined 1 day,2 days and 7 days postoperatively.Pathologic examination of the corresponding tissues was also carried out 1 week after the animals were sacrificed.The data were analyzed by SPSS 13.0 statistical software.This experiment followed the Administration of the Care and Use of Experimental Animals of Shanghai City.Results The conjunctival and skin lacerations healed well both in the suture group and the medical glue group.The levels of tear secretion 1 day and 2 days postoperatively in the medical glue group were (12.70±2.21)mm and (12.70±2.00)mm respectively,showing a significant lowness in comparison with (14.90±2.38)mm and (14.90±2.33)mm of the suture group (q =-4.02,P =0.03;q =-4.02,P =0.03).Compared with the baseline,the difference of the levels of tear secretion in the medical glue group was not statistically significant in various time points after operation (P=1.00,1.00,0.51).The BUT values at 2 days and 7 days postoperatively in the medical glue group were (4.50 ± 1.18) seconds and (4.10±0.88) seconds respectively,being significantly longer than (3.30 ± 1.06) seconds and (3.00±1.25) seconds in the suture group (q=4.37,P=0.02;q=4.19,P=0.03).Compared with the baseline,there was not statistically significant difference at each time point postoperatively in the medical glue group (P =0.28,0.59,0.21).However,BUT at each time point after operation in the suture group was significantly shorter than that of the baseline (P=0.01,0.01,0.00).Pathological examination showed that all the conjunctival and skin lacerations healed well.Trivial collagen hyperplasy was seen in the eyes of the suture group and infiltration of a few of inflammatory cells was found in the medical glue group.In the pathological result of the skin test,there was conspicuous scar and severe collagen hyperplasy in the suture group,but in the medical glue group,the skin structure was almost normal.Conclusions α-Cyanoacrylate is safe and effective for the repair of the conjunctival incision with little affection to ocular surface microenvironment.
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Background The pathological foundation of diabetic retinopathy is the breakdown of the bloodretina barrier induced by multifactors.Objective This study was to investigate the retinal morphologic change and the levels of serum vascular endothelial growth factor(VEGF),endothelin(ET)and nitric oxide(NO)in diabetic rats.Methods Forty healthy female SD rats were randomly divided into experimental group and control group and 20 rats for each group.Acute diabetes models were established by the intraperitoneal injection of 60 mg/kg streptozotocin in experimental group and the equal volume of buffer solution was injected at the same way in the control group.The serum VEGF level,ET level and NO concentration of diabetic and control rats were detected using ELISA double antibody sandwich method,125I radioimmune method and nitrate reduction method respectively at 2,4,6 and 8 weeks after injection.The eyeballs of rats were enucleated at the eighth week for retinal pathologic examination.This experiment followed the Measures for the administration of experimental animals of Shanghai City.Results The retinal structure was normal throughout the experimental duration in the control group.However,retinal edema and cellular disorganization appeared at 4 months and retinal blooding could be seen with the extending of diabetes course.The levels of serum VEGF and ET in each experimental group were significantly higher than those in control groups(P＜0.05).The levels of serum NO elevated in 2-month experimental group compared with same-phase control group(Z =-2.193,P＜0.05),and those in 6-and 8-month experimental groups were significantly lower than in corresponding control groups(Z =-2.449,Z =-2.236,P＜0.05).With the progression of the disease,the levels of VEGF and ET increased gradually,but the levels of NO decreased gradually,showing statistically significant differences(P＜0.05).The level of serum VEGF showed a positive correlation with serum ET level and a negative correlation with the serum NO concentration(r=-0.814,r=-0.803,P＜0.01)in the experimental group.A negative leaner relation was also found between serum ET level and serum NO concentration(r=0.821,P＜0.01).Conclusions The serum VEGF,ET and NO levels are closely associated with the degree of retinal lesion in early diabetic models.These results suggest that serum VEGF,ET and NO levels may be the important indexes predicting the course of retinal disease in diabetic rats.
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Objective To evaluate the safety of a surgical appwach for transabdominal cardial carci- noma.Methods We retrospectively analyzed 326 patients undergoing transabdominal esophagastrostomy or esophagojejunostomy from 1998 to 2006 via the EEA(end-to-end anastomosis)stapler.Results By the surgi- cal approach for transabdominal cardial carcinoma,the average length of reseete esophagus above the carci- noma was about 6～8 cm realized the low average of remnant carcinoma at the margin and operation mortality and anastomotic leakage,which was lower than those in the thoraeotomy appmaeh significantly.Conclusion The transabdominal approach makes a clear operative field in posterio-inferior mediastinum,it is beneficial for radical resection of eardial carcinoma and intramediastinal esophagogastric or esophagojejunal mechanical anastomosis,and it fits to the old,the weakening and with the disease of heart and lung.
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Objective To study the clinical characteristics and curative effects of pancreatic cystade- nocarcinoma in order to improve its diagnostic and therapeutic accuracy.Methods A retrospective analysis was done on the clinical materials of 13 cases of pancreatic cystadenocarcinoma hospitalized in Shanxi Cancer Hospital from 1990 to 2006.Results The preoperative diagnosis were as follows:pancreatic cystadenocarci- noma 6 cases,pancreatic cystadenoma 2 cases,pancreatic cancer 1 case,pancreatic pseudocyst 4 cases.The misdiagnosis rate was 53.8 %.Surgical operation was done on the 13 cases,and 10 of them were treated by radical operation.A 5-year follow-up was done on 6 still alive cases,and 1 of them lived over 11 years.3 cases were treated by palliative operation,and all of them died within 3 years.Conclusion Since there is no specific clinical manifestations of pancreatic cystadenocarcinoma,it is very difficult to get an accurate preop- erative diagnosis.Radical operation is the most effective therapeutic methods.