Clinical metagenomic sequencing for rapid diagnosis of neonatal meningitis caused by Ureaplasma parvum: A case report.

INTRODUCTION: It is challenging to obtain favorable results through conventional diagnostic testing for Ureaplasma parvum (UP), a conditional pathogen, because of the atypical clinical phenotype of UP meningitis. PATIENT CONCERNS AND DIAGNOSIS: Herein, we report a pediatric case of neonatal meningitis caused by UP in a spontaneously delivered full-term baby. The infant's temperature peak was 38.3°C at the age of 9 days. The patient was diagnosed with neonatal suppurative meningitis. INTERVENTIONS AND OUTCOMES: The pathogen was diagnosed in a timely and accurate manner by metagenome sequencing, and the patient was eventually discharged with azithromycin. CONCLUSIONS: Neonatal Ureaplasma meningitis may be more common than previously suspected. The clinical manifestations were not obvious and were similar to those of neonatal meningitis caused by other bacteria. When conventional treatments and conventional pathogenic tests are negative, mNGS is a better choice for timely and accurate pathogen identification.

Feasibility and Efficacy of Pulsed-Dose Oxygen Delivery During Noninvasive Ventilation.

BACKGROUND: It is difficult to apply noninvasive ventilation (NIV) simultaneously with pulsed-dose oxygen delivery. We evaluated the feasibility and efficacy of pulsed-dose oxygen delivery during NIV. METHODS: A bench study was conducted using a simulated lung during NIV, with a breathing frequency of 10 or 20 breaths/min and 3 oxygen injection sites (site A on face mask, site B proximal to face mask, and site C at the ventilator outlet) with continuous flow oxygen delivery of 1, 3, or 5 L/min) or pulsed-dose oxygen delivery (numerical settings of 1, 3, or 5 representing the oxygen pulse characteristics). [Formula: see text] under different experimental conditions and the influence of mode of oxygen delivery on NIV (compared to baseline and continuous flow oxygen delivery vs pulsed-dose oxygen delivery) were compared. In the clinical study, we enrolled 10 subjects with COPD exacerbation who received NIV with either continuous flow oxygen delivery or pulsed-dose oxygen delivery. Under the same targeted pulse oxygen saturation (88-92%), the numerical settings of different modes of oxygen delivery were titrated, and the clinical parameters during the different modes of oxygen delivery were compared. RESULTS: In the bench study, the ratio of the [Formula: see text] with pulsed-dose oxygen delivery to the [Formula: see text] with continuous flow oxygen delivery at the same numerical setting was 0.94 ± 0.15. The oxygen injection site had a significant influence on [Formula: see text] in pulsed-dose oxygen delivery or continuous flow oxygen delivery mode (P < .05). Pulsed-dose oxygen delivery worked effectively with the ventilator, as demonstrated by the fine synchronization in the breathing cycle of the ventilator, the simulated lung, and the pulsed-dose oxygen delivery. When compared with each other or compared to the baseline individually, pulsed-dose oxygen delivery and continuous flow oxygen delivery showed no clinically important effects on NIV (all P > .05 or changes < 10%). In the clinical study, the mean numerical settings for pulsed-dose oxygen delivery and continuous flow oxygen delivery modes after titration were 2.68 ± 0.32 and 2.31 ± 0.56 L/min, respectively. There was no significant difference between continuous flow oxygen delivery and pulsed-dose oxygen delivery (P > .05). CONCLUSIONS: Integration of pulsed-dose oxygen delivery into NIV could achieve efficacy similar to that achieved with continuous flow oxygen delivery.

Isoflavanones from Desmodium oxyphyllum and their cytotoxicity.

Two new isoflavanones, (3R)-7-hydroxy-4'-methoxy-5-methoxycarbonyl-isoflavanone (1) and (3R)-8-hydroxy-4'-methoxy-7-methoxycarbonyl-isoflavanone (2), together with seven known isoflavanones (3-9) were isolated from Desmodium oxyphyllum of the Leguminosae family. Their structures were elucidated by spectroscopic methods, including extensive 1D and 2D NMR techniques. Compound 1 showed good cytotoxicity against NB4 and SHSY5Y cell lines with IC50 values of 3.1 and 2.5 µM; compound 2 exhibited cytotoxicity against PC3 cell lines with a IC50 value of 3.6 µM; compound 4 showed cytotoxicity against A549 and SHSY5Y cell lines with IC50 values of 3.6 and 2.8 µM; and compound 5 displayed cytotoxicity against NB4, SHSY5Y, and MCF7 cell lines with IC50 values of 2.6, 3.8, and 2.8 µM, respectively. Other compounds also showed moderate cytotoxicity for some tested cell lines with IC50 values between 5.4 and 8.8 µM.