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Objective:To explore the application value of metagenomics sequencing in the etiological diagnosis of bacterial meningitis(BM) in children and improve the diagnosis and treatment effect of BM in children.Methods:All BM cases were collected from Jiangxi Provincial Children′s Hospital from February 1, 2018 to January 31, 2020.Meanwhile, such biological samples as blood and cerebrospinal fluid were collected for traditional etiological testing and metagenomics sequencing.The results of traditional etiological testing were regarded as the gold standard, and the specificity and sensitivity of metagenomics sequencing in the diagnosis of BM in children were confirmed.Results:A total of 45 cases were collected in this study, including 31 males and 14 females, with the age between (74.74 ± 58.67) months.Twenty-six cases were identified by metagenomics sequencing, with the positive rate being 57.78%.Among them, there were 8 cases of Streptococcus pneumoniae, 2 cases of Escherichia coli, 2 cases of Neisseria meningitidis, 2 cases of Staphylococcus, 2 cases of Salmonella, 2 cases of Mycobacterium multiplex, 1 case of Streptococcus intermedius, 1 case of Streptococcus pyogenes, 1 case of Streptococcus paris, 1 case of Streptococcus salivarius, 1 case of Haemophilus influenzae, 1 case of Pseudomonas aeruginosa, 1 case of Acinetobacter baumannii, and 1 case of Aspergillus.The traditional etiological positive rate was 17.78%, and the metagenomic next-generation sequencing (mNGS) positive rate was 57.78% ( P=0.014, kappa=0.273). As per the comparison results, the sensitivity, specificity, positive predictive value, negative predictive value, Youden index and misdiagnosis rate were 100.00%, 51.35%, 30.76%, 100.00%, 51.36%, 48.64% and 0, respectively. Conclusions:Metagenomics examination had high sensitivity, which can improve the etiological diagnosis rate of acute BM in children, especially in case of high clinical suspicion of infection.Therefore, metagenomics examination should be selected as early as possible when the etiology cannot be determined by traditional approaches.
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Multiple sclerosis (MS) is one of the most important autoimmune diseases characterized mainly by white matter damage in the central nervous system.A total of 2.2％ to 4.4％ of MS population are children and adolescence,which has attracted increasing attention.About 80％ of the pediatric cases and nearly all adolescent onset patients present with attacks typical to adult MS.Approximately 97％ to 99％ of the affected children suffer relapsing-remitting MS,which is higher than that of the adults.MS in children is associated with more frequent and severe relapses.The treatment of MS in children is similar with that in adults,but with their own characteristics.The review focuses on the progress in the treatment of MS in children.
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Objective To observe the effect of continued nursing on the long-term nasal feeding to elderly patients after discharge.Methods Toally 60 elderly discharged patients between January 2014 to December 2014 were evenly divided into observation and control groups with radom digit table the control group received routine nursing before discharge and after it and the observation group received continued nursing.The two groups were compared in terms of nasal feeding-induced complication,nursing satisfaction,care capability of patients' caregivers.Result The complication rate in the observation group was significantly lower,the nursing satisfaction was significantly higher and the care capability of caregivers were significantly better as compared to those of the control group (P ＜0.05).Conclusion Continued nursing can improve nursing satisfaction,train the care capacity of caregivers,reduce the complications for the old patients who need long-term nasal feeding after discharge.
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Objective To investigate the impact of chronic renal insufficiency on serum levels of protein induced by vitamin K absence or antagonist‐Ⅱ(PIVKA‐Ⅱ) and sialic acid (SA) .MethodsThe levels of serum PIVKA‐Ⅱ ,SA ,urea and creatinine(Cr) were detected in 127 cases of chronic renal insufficiency ,32 cases of renal disease with normal renal function ,57 healthy controls un‐dergoing the physical examination and 120 cases of hepatocellular carcinoma (HCC ) by using the chemiluminescent and enzymatic methods respectively .The serum urea and creatinine levels were also measured .The estimated GFR (eGFR) was calculated .Results The serum PIVKA‐Ⅱ level had no statistical difference in among the healthy control group ,renal disease with normal renal func‐tion group and renal disease with renal insufficiency group (H=2 .902 ,P> 0 .05) ,moreover significantly lower than that in the HCC group (U=319 .5 ,203 .00 ,665 .50 respectively ,P0 .05) .However ,serum SA levels had statistical differences among the healthy control group ,disease complicating normal renal function group and disease complicating renal insufficiency group( H = 63 .685 ,P0 .05) .Conclusion The renal insufficiency has no obvious im‐pact on serum PIVKA‐Ⅱexpression ,but could significantly increase the SA expression level ,moreover is closely related with the se‐verity of renal function impairment ,thus indicating that the SA level increase not only has the assisted diagnosis value on HCC and multiple malignant tumors ,but also better reflects the renal function status in the patients with chronic renal insufficiency .