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We report a case of maternal asymptomatic COVID-19 in a patient with typical CT image of pneumonia in the third trimester, and both the mother and baby were well. The patient, a 30-year-old female, was transferred to Yichun People's Hospital at 37 +3 gestational weeks because of a positive 2019 novel coronavirus nucleic acid result over seven hours. Her husband and mother-in-law were diagnosed with COVID-19 eight days before her admission and on the same day, respectively. The patient reported no discomfort before admission, and there were no abnormalities in the prenatal course during her pregnancy. On February 13 (the second day of admission), a patchy blurred shadow was observed in the lower lobe of the right lung in chest CT scan, and a live baby girl was delivered by a precaution-based emergent cesarean section because of suspected fetal distress shown in electrical fetal heart monitoring. Both the mother and the newborn were isolated separately after the operation without etiological examination of amniotic fluid, umbilical cord blood, placenta, etc. All the medical staff involved in the cesarean section were isolated as well. The mother was healthy and remained asymptomatic after delivery, while antiviral and anti-inflammatory treatment was offered. COVID-19 nucleic acid tests of pharyngeal swab were negative on the 4 th and 6 th day after operation. Chest CT on the 5 th day after delivery showed inflammation in the lower lobe of the right lung, and reexamination on the 8 th day showed a slight absorption of the inflammation. Samples of peripheral blood and pharynx swab were obtained from the newborn on the day of birth and four and seven days after birth and novel coronavirus nucleic acid test were all negative. The mother and baby dyad were discharged nine days after operation. And novel coronavirus nucleic acid tests were all negative in all medical staff involved.
ABSTRACT
We report a case of maternal asymptomatic COVID-19 in a patient with typical CT image of pneumonia in the third trimester, and both the mother and baby were well. The patient, a 30-year-old female, was transferred to Yichun People's Hospital at 37 +3 gestational weeks because of a positive 2019 novel coronavirus nucleic acid result over seven hours. Her husband and mother-in-law were diagnosed with COVID-19 eight days before her admission and on the same day, respectively. The patient reported no discomfort before admission, and there were no abnormalities in the prenatal course during her pregnancy. On February 13 (the second day of admission), a patchy blurred shadow was observed in the lower lobe of the right lung in chest CT scan, and a live baby girl was delivered by a precaution-based emergent cesarean section because of suspected fetal distress shown in electrical fetal heart monitoring. Both the mother and the newborn were isolated separately after the operation. All the medical staff involved in the cesarean section were isolated as well. The mother was healthy and remained asymptomatic after delivery, while antiviral and anti-inflammatory treatment was offered. COVID-19 nucleic acid tests of pharyngeal swab were negative on the 4 th and 6 th day after operation. Chest CT on the 5 th day after delivery showed inflammation in the lower lobe of the right lung, and reexamination on the 8 th day showed a slight absorption of the inflammation. Samples of peripheral blood and pharynx swab were obtained from the newborn on the day of birth and four and seven days after birth, and novel coronavirus nucleic acid test were all negative. The mother and baby dyad were discharged nine days after operation. And novel coronavirus nucleic acid tests were all negative in all medical staff involved.
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Objective:To evaluate the application values of intraaortic palloon pumping in the treatment of acute left heart failure.Methods:From February 2013 to January 2016,102 patients in our hospital for diagnosis and treatment of acute left heart failure were selected as the research object,all the patients were equally divided into the observation group and control group with 51 patients in each group according to the random draw envelope principle.The control group was given routine drug treatment,the observation group was given intraaortic palloon pumping treatment based on the treatment in control group,the prognosis of two groups were observed and compared between two groups.Results:The total effective rate of observation group and control group were 96.1% and 84.3 %,respectively,which was significantly higher in the tobservation group than that of the control group (P<0.05).The LVEF values in the observation group and control group after treatment were 65.22 ± 4.52 % and 58.20 ± 5.31% respectively,which were significantly higher than those before treatment 45.29± 5.14 % and 45.20± 4.89 %,and the LVEF value of observation group was significantly higher than that of the control group (P<0.05).After 6 months' treatment,the incidence of death,refractory ischemia,malignant arrhythmia and other recent primary end points in the observation group was 5.9 %,the control group was 21.6 %,which was significantly higher than that of the observation group (P<0.05).Conclusion:Aortic balloon pump implantation could promote the improvement of left ventricular function,improve the treatment effect,reduce the occurrence of recent primary end point event in the treatment of acute left heart failure.
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Objective To explore the morbidity and clinical characteristics of mumps meningoencephalitis in children without parotitis.Methods Two hundred and twenty-three cerebrospinal fluid (CSF) specimens were collected from children who were diagnosed as viral encephalitis at Department of Pediatrics,the Second Affiliated Hospital of Shantou University Medical College from June 2010 to February 2016.Multiplex PCR was applied to detect the mumps virus,and other common viral,including measles virus,enterovirus,enterovirus 71 type,coxsackie virus A16 type,dengue virus,Japanese encephalitis virus,rubella virus,herpes simplex virus,human cytomegalovirus,Epstein-Barr virus,Chikungunya virus and Charon evagatus in mumps virus positive specimens were detected by PCR.The clinical data of patients with mumps virus infection were analyzed.Results In 223 CSF specimens,positive mumps virus were detected in 11 cases (4.9%),of whom,the mycobacterial,fungal,conventional CSF cultures and other common viral cause in CSF were negative.One case presented parotitis on the sixth day after admission.Of 11 cases with positive mumps virus,there were 10 cases without parotitis.The cardinal symptoms of mumps meningoencephalitis in children without parotitis were fever,headache,vomiting and seizures,and the CSF parameters,brain magnetic resonance imaging,electroencephalogram ofthe patients were all similar to other viral encephalitis,while the prognosis was good in children with mumps meningoencephalitis without parotitis,but the CSF return to normal needed a long time,the longest time up to 4 weeks.Conclusion Mumps meningoencephalitis may occur in children without parotitis,and the most common symptom are fever,headache,vomiting and seizures.
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Background Fungal keratitis has a high incidence in China and its clinical treatment is very difficult,and its etiology diagnosis and appraisal is the premise to improve the prognosis of disease.With the changes of regional environment and climate in recent years,whether the spectrum of fungal keratitis change in South China is remarkable.Objective The purpose of this study was to investigate recent pathogenic distribution of fungal keratitis in South China area.Methods The consecutive fungal culture resuhs of 3 350 purulent keratitis at Zhongshan Ophthalmic Center from January 2009 to December 2014 were retrospectively reviewed.The positive rate of fungal culture,genus or species distribution,seasonal distribution and different term distribution were analyzed.Results The culture-positive rate was 31.34% in this study (1 050/3 350),and the average culture-positive number was 175 strains per year.In the positive fungus,the highest positive rate was Fusarium SP (32.10%,337/1 050),and followed by Aspergillus SP (25.71%,270/1 050),Heminthosporium SP (14.29 %,150/1 050) and Mucor SP (9.14%,96/1 050).The fungal culture-positive rate was 36.05% (367/1 018) in 2009 to 2010,32.45% (324/1 014) in 2011 to 2012,and 26.86% (354/1 318) in 2013 to 2014,respectively,with a significant difference among the three periods (x2 =22.37,P<0.01),showing a decreasing tendency of incidence.Two hundreds and sixtyone strains were isolated from January to March (31.15 %,261/838),182 strains from April to June (25.53 %,182/713),237 strains from July to September (30.00%,237/790),370 strains from October to December (36.67%,370/1 009),showing a statistically significant difference among them (x2 =25.19,P < 0.01).The number of infectious strains was most during October to December and fewest during April to June.Conclusions The leading pathogenic fungi of fungal keratitis is Fusarium SP and followed by Aspergillus SP,Helminthosporium SP,Mucor SP in turn.Fungal keratitis is usually prevalent from October to December,and its incidence is still rising in Chinese mainland recently.However,the increasing tendency in South China has been prevented in recent six years.
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Objective To study the significance of human rhinovirus C as a pathogen and the clini-cal features of human rhinovirus C infection in pediatric intensive care unit. Methods From November 2010 to April 2012,570 nasopharyngeal aspirates specimens were collected from children who were admitted to the pediatric intensive care unit with respiratory infections. Nest reverse transcription-polymerase chain reactions were applied to detect the human rhinovirus C. The other common respiratory viruses were detected by multi-plex polymerase chain reaction. The clinical data were collected. Results One hundred and seventy human rhinovirus positive samples ( 29. 8%) were detected in 570 nasopharyngeal aspirates specimens. The VP2/VP4 and 5′UTR region of the human rhinovirus genome was amplified from 170 human rhinovirus positive samples with 80. 6%(136/170) success. While 20. 0%(34/170) samples in total were unclassified to spe-cies. There were 85 single infected samples including 52 of type A,7 of type B,26 of type C. The nucleotide homology was 74. 0% to 99. 2% and the nucleotide variations was 3. 4% to 32. 3% in stains of human rhino-virus C. The late fall and early winter were the epidemic seasons of human rhinovirus C infection. Cough,fe-ver, polypnea and wheezing were the common symptoms. Conclusion Human rhinovirus C is the major cause of infectious disease in pediatric critical illnesses. Human rhinovirus C infections often cause cough, fever,polypnea and wheezing.
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Objective To analyze the clinical features of PICU patients with bocaviral infection.Meth-ods Nasopharyngeai aspirates specimens were collected from 450 children who were admitted to PICU with a-cute respiratory tract infection in our hospital from June 2010 to December 2011 .Multiplex PCR was applied to detected human bocavirus and emerging respiratory virus.Bocavirus positive PCR results were sequenced and the clinical data of the positive cases were analysed.Results Human bocavirus positive samples were detected in 30 cases(6.7%) among 450 throat swab specimens.Human bocavirus as a single infection was found in 16 cases (53.3%).Mixed infections were found with in 14 cases(46.7%) of 30 positive samples.According to pediat-ric critical illness score,there were 13 cases of non-serious,2 cases of serious and 1 case was extremely serious in 16 single infections cases.There were 12 cases of non-seriuo s and 2 serious cases in 14 mixed infections. There were no statistically significant differences between single and mixed infections in the severity of the dis-ease( P>0.05 ) .Conclusion Bocavirus can cause severe respiratory tract infections.Mixed infections does not increase the severity of the disease.
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The cystic fibrosis transmembrane conductance regulator (CFTR) is a unique member of the ATP-binding cassette (ABC) transporter superfamily that forms a Cl(-) channel with complex regulation. CFTR is composed of five domains: two membrane-spanning domains (MSDs), two nucleotide-binding domains (NBDs) and a unique regulatory domain (RD). The MSDs assemble to form a low conductance (6-10 pS) anion-selective pore with deep intracellular and shallow extracellular vestibules separated by a selectivity filter. The NBDs form a head-to-tail dimer with two ATP-binding sites (termed sites 1 and 2) located at the dimer interface. Anion flow through CFTR is gated by the interaction of ATP with sites 1 and 2 powering cycles of NBD dimer association and dissociation and hence, conformational changes in the MSDs that open and close the channel pore. The RD is an unstructured domain with multiple consensus phosphorylation sites, phosphorylation of which stimulates CFTR function by enhancing the interaction of ATP with the NBDs. Tight spatial and temporal control of CFTR activity is achieved by macromolecular signalling complexes in which scaffolding proteins colocalise CFTR and plasma membrane receptors with protein kinases and phosphatases. Moreover, a macromolecular complex composed of CFTR and metabolic enzymes (a CFTR metabolon) permits CFTR activity to be coupled tightly to metabolic pathways within cells so that CFTR inhibition conserves vital energy stores. CFTR is expressed in epithelial tissues throughout the body, lining ducts and tubes. It functions to control the quantity and composition of epithelial secretions by driving either the absorption or secretion of salt and water. Of note, in the respiratory airways CFTR plays an additional important role in host defence. Malfunction of CFTR disrupts transepithelial ion transport leading to a wide spectrum of human disease.