Clinical analysis of 39 patients with parapneumonic pleural effusion caused by streptococcus anginosus group / 中国医师进修杂志

Objective:To explore the clinical characteristics, chest imaging manifestations, RAPID score and therapeutic situation in patients with parapneumonic pleural effusion (PPE) caused by streptococcus anginosus group (SAG), in order to provide help for the early diagnosis and treatment in clinical practices. Methods:The clinical data of 39 patients with PPE caused by SAG from January 2015 to May 2020 in Affiliated Hospital of Jining Medical University and Jining First People′s Hospital were retrospectively analyzed. The patients were classified by RAPID score.Results:Among 39 cases, males was in 31 cases (79.5%), females in 8 cases (20.5%), and aged 46 to 89 (65.31±10.53) years old. Fever was in 27 cases (69.2%), chest pain in 19 cases (48.7%), and dyspnea in 18 cases (46.2%). The chest CT findings showed consolidation shadows was in 30 cases (76.9%), encapsulated pleural effusion in 21 cases (53.8%), ground glass shadow in 18 cases (46.2%), nodules in 12 cases (30.8%), atelectasis in 8 cases (20.5%), and pneumothorax in 5 cases (12.8%). The complexity PPE was in 23 cases (59.0%), and empyema in 16 cases (41.0%). The microbiological culture results showed that streptococcus constellatus was detected in 25 cases (64.1%), streptococcus anginosus in 13 cases (33.3%), and streptococcus intermadius in 1 case (2.6%). After comprehensive treatment, 36 cases (92.3%) were improved, 3 cases (7.7%) died. According to the RAPID score, low-risk was in 13 cases (33.3%), intermediate-risk in 16 cases (41.0%), and high-risk in 10 cases (25.7%). The RAPID score in patients with low-risk, intermediate-risk and high-risk was (1.85 ± 0.38), (3.43 ± 0.51) and (5.30 ± 0.67) scores, and there was statistical difference ( F = 124.88, P<0.05). the length of stay in patients with low-risk, intermediate-risk and high-risk of RAPID score was (16.84 ± 5.57), (16.56 ± 7.05) and (28.20 ± 17.97) d, and there was statistical difference ( F = 4.41, P<0.05); the length of stay in patients with high-risk was significantly longer than that in patients with low-risk and intermediate-risk, and there was statistical difference ( P<0.05), there was no statistical difference between intermediate-risk patients and low-risk patients ( P>0.05). Conclusions:SAG, as important pathogens for the PPE, tends to induce CPPE and even pyopneumothorax. Clinical manifestations and imaging are not specific, which should be payed attention in clinical work. The patients with high-risk of RAPID score have more serious condition and worse prognosis.

Molecular cytogenetic study of a case with ring chromosome 15 / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a patient featuring developmental delay.@*METHODS@#The patient and her parents were subjected to G- and C-banded chromosomal karyotyping analysis. The proband was also analyzed by single nucleotide polymorphism microarray (SNP-array). The result was verified by using fluorescence quantitative PCR (qPCR).@*RESULTS@#The proband's karyotype was ascertained as 46,XX, r(15)(p11.2q26.3)[92]/45,XX,-15[9]/46,XX, dic r(15)(p11.2q26.3;p11.2q26.3)[4]. SNP-array revealed that she has carried a de novo deletion at 15q26.3 (98 957 555-102 429 040) spanning approximately 3.4 Mb, which encompassed the IGF1R gene. qPCR has confirmed haploinsufficiency of exons 3, 10 and 20 of the IGF1R gene. Both of her parents had a normal karyotype.@*CONCLUSION@#The abnormal phenotype of the proband may be attributed to the microdeletion at 15q26.3, in particular haploinsuffiency of the IGF1R gene and instability of the ring chromosome. Cytogenetic method combined with SNP-array and qPCR can efficiently delineate chromosomal aberrations and provide accurate information for clinical diagnosis and genetic counseling.

Clinical characteristics of Streptococcus milleri infection: an analysis of 159 cases / 中华全科医师杂志

A total of 159 patients with Streptococcus milleri (S. milleri) infection were diagnosed in our hospital between January 2014 and January 2019. The demographic data, underlying diseases, infection sites, laboratory tests, and prognosis of patients were retrospectively analyzed; the clinical and microbiological data were compared among different age groups. Of the 159 patients there were 103 were males and 56 females; there were 19 patients aged<18 years [(8.1±5.3) years], 113 patients aged ≥18 and < 65 years [(45.5±13.1) years] and 27 patients aged ≥65 years[(74.7±8.6) years]. The incidence peaked in the 34-55 year age group (50 cases, 31.4%). Streptococcus anginosus was identified in 97 cases (61.0%), Streptococcus constellatus in 55 patients (34.6%) and Streptococcus intermedius in 7 cases (4.4%). The abdomen (44 cases, 27.7%) and the chest (19 cases, 11.9%) were the main involving sites. For patients younger than 18 years and those aged ≥18 and<65 years, suppurative appendicitis was the most common condition[12 cases(12/19) and 21 cases(18.6%), respectively]; while in patients aged ≥65 years, chest infection ranked the first (9 cases, 33.3%). All 159 patients were treated with anti-infection therapy alone or anti-infection and invasive procedures with a favorable prognosis, 2 patients died with a overall fatality rate of 1.3%.

Application of next generation sequencing for the analysis of patients with spontaneous abortion / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the value of next generation sequencing (NGS) for the analysis of spontaneous abortion samples.</p><p><b>METHODS</b>The NGS analysis was carried out on 85 chorionic villi samples (taken between 42 days to 12 weeks of gestation) for which conventional cell culture has failed or chromosomal karyotyping has yielded normal or uncertain result.</p><p><b>RESULTS</b>Among 68 samples with a normal karyotype, the NGS analysis has identified 2 copy number variations (CNVs) and 2 chimeras. For 16 cases with failed cell culture, the NGS has identified 4 chromosomal abnormalities including 1 copy number variation and 3 numerical chromosomal aberrations. For 1 remaining case with uncertain karyotyping result, the NGS analysis has verified it as 46,XX,del(4) (p15.1p16.3).seq[GRCh37/hg19] (57 549 - 32 371 364)×1.</p><p><b>CONCLUSION</b>The NGS analysis is capable of identifying novel CNVs in samples for which conventional cell culture may fail or karyotyping analysis may yield a normal result.</p>

Clinical analysis of endobronchial aspergilloma / 中国内镜杂志

Objective To discuss the clinical feature of endobronchial aspergilloma approach strategy for diagnosis and therapy. Methods 2 cases of endobronchial aspergilloma were diagnosed and literature review were made in this study. The clinical manifestation, bronchoscopic characters, imaging performances were retrospectively studied. Results The most common complaint was bloody sputum or mild hemoptysis, and chest CT usually revealed a soft tissue mass shadow with the increasing popularity of flexible bronchoscopy, it is being recognized as a necrotic mass causing bronchial obstruction, with or without a parenchymal lesion in cavity. Conclusions Bronchoscopy maybe is the key approach to detect endobronchial aspergilloma. It should be alert to lung cancer when antifungal therapy is not effective and the lesions have no reduction or even increasing.

Systematic genetic analysis for a case with duplication 9p / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify the genetic cause for a case with growth retardation and mental retardation.</p><p><b>METHODS</b>After conventional peripheral blood karyotyping with G-banding, the abnormal chromosome was identified as suspicious 9p duplication by multiplex ligation dependent probe amplification (MLPA) .</p><p><b>RESULTS</b>The proband's karyotype was suspicious 46,XY,der(9)t(9;14)(q13;q11.2), then the abnormal chromosome 9 was identified as 9p duplication with MLPA. The 9p duplication occurs because of a balanced chromosomal rearrangement between two chromosomes of 9 and 14 in the proband's father.</p><p><b>CONCLUSION</b>9p11.2-p24.3 duplication is the cause of abnormal phenotypes in the child patient. Cytogenetic methods combined with MLPA can efficiently identify abnormal chromosomes and provide accurate results for clinical diagnosis and treatment.</p>

Genetic analysis of a family with super-male syndrome / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify the genetic cause for a family featuring language retardation using combined cytogenetic and molecular genetic methods.</p><p><b>METHODS</b>Following conventional G-banded karyotype analysis, the additional Y chromosome was identified by fluorescence in situ hybridization (FISH) and multiplex ligation dependent probe amplification (MLPA). Whole genome array comparative genomic hybridization (aCGH) was also carried out to detect minor structural chromosomal abnormalities.</p><p><b>RESULTS</b>The proband's karyotype was determined as 47,XY,+?, and the unknown aberrant chromosome was identified as Yqh+ with FISH, MLPA and aCGH. No other chromosomal abnormality was found in the pedigree.</p><p><b>CONCLUSION</b>Cytogenetic methods combined with FISH, MLPA, and aCGH can efficiently identify the origin of unknown chromosomes and provide accurate clues for clinical diagnosis and treatment.</p>

Impact of NK cells on multiple myeloma cell line KM-3 / 白血病·淋巴瘤

Objective To study the apoptosis of multiple myeloma cell line KM-3 induced by NK cells. Methods WST-1 assay was used to detect the killing effect of KM-3 cells treated with NK cells at different effector(E):target(T) ratio. Flow cytometry was applied to analyze Annexin-V+/PI- apoptotic cells and the mitochondrial transmembrane potential. Results NK cells could significantly kill KM-3 cells in a dosand time-dependent manner (P <0.05). After KM-3 cells- were treated with NK cells for 48 hours, the Annexin-V+/PI- cells were increased obviously in dose-dependence (P <0.05). The Annexin-V+PI- cells were increased in time-dependence when treated with NK cells(E:T ratio at 10:1) (P<0.05). The mitochondrial transmembrane potential of KM-3 cells treated with NK cells were significantly decreased in dose-and time-dependence (P < 0.05). Conclusion NK cell can kill KM-3 cells and induce apoptosis in a dose-and time-dependence manner.

Effect of vitamin E and fructose 1,6-diphosphate on lipid peroxidation in erythrocytes during artificial total knee replacement / 中国组织工程研究

BACKGROUND:Recent studies have demonstrated that surgical trauma leads to lipid peroxidation in erythrocytes.However,injured erythrocytes play an important role in thrombosis following replacement.OBJECTIVE:To evaluate the influence of artificial total knee replacement on the lipid peroxdation in erythrocytes,and the prophylactic treatment of vitamin E and fructose 1,6 diphosphate(FDP)on it.DESIGN,TIME AND SETTING:Contrast clinical study,which was carried out in the Department of Otthopaedics,Affiliated Hospital of Nantong University from January 2003 to June 2006.PARTICIPANTS:Sixty patients with knee osteoarthritis who underwent artificial total knee replacement by anesthesia of epidural block were divided into four groups,including control group,vitamin E group,FDP group and vitamin E+FDP group,with 15 cases in each group.METHODS:Vitamin E was orally taken in the vitamin E group three days before replacement,three times a day,100 mg for each.The administration was performed until the surgical morning.Thirty minutes after the operation,FDP(10 g)was intravenously dripped in the FDP group.Additionally.vitamin E was also orally taken in the vitamin E+FDP group three days before replacement,three times a day,100 mg for each;on the surgical morning,FDP(10 g)was intravenously dripped on the first 30minutes.Blood samples were taken for biochemical determination before and after the operation at 1,3,5,and 7 days.MAIN OUTCOME M[EASURES:Corltents of malonaldehyde(MDA)and cuprum/zincum/superoxide dismutase (Cu-Zn-SOD)in the erythrocytes.RESULTS:MDA level in the vitamin E group and FDP group was significantly higher than that in the vitamin E+FDP group before and 5 and 7 days after replacement(P<0.05);while,Cu-Zn-SOD level was significantly lower(P<0.05).Otherwise,there were no significant differences in vitamin E+FDP group before and after replacement(P>0.05).CONCLUSION:The artificial total knee replacement can enhance lipid peroxidation and decrease antioxygen capability.However,the combination of vitamin E and FDP can prevent and relieve lipid peroxidation and antioxygen capability after replacement.

Effect of the lipid peroxide in erythrocytes in total knee replacement / 中国矫形外科杂志

[Objective] To evalvate the influence of total knee replacement(TKR)on the lipid peroxdation in erythrocytes,and the prophylactic treatment of Vitamin E and fructose 1,6-diphosphate(FDP)on it.[Method]Totally 60 patients of knee osteoarthritis were divided into control group,Vitamin E group,Fructose 1,6-diphosphate(FDP)group and Vitamin E added FDP group.Blood samples were taken for biochemical determination of MDA and Cu-Zn-SOD before and after the operation at 1,3,5 and 7 days.[Result]MDA level in erythrocytes increased singnificantly after TKR compared with that before operation(P