Cloacal malformation: A rare case report and review of prenatal imagings.

RATIONALE: Cloacal malformation (CM) is a serious type of anorectal and urogenital tract malformation. However, prenatal ultrasound (US) detection of CM is challenging. In this paper, we reported a rare case of CM prenatally diagnosed by US and magnetic resonance imaging (MRI), as well as reviewed the prenatal US and MRI characteristics of CM in the literature. PATIENT CONCERNS: A 30-year-old pregnant woman complained of cystic mass in the fetal abdomen detected by prenatal US. DIAGNOSIS: Fetus CM. INTERVENTIONS: The fetus was diagnosed as fetal CM by US and MRI, then the pregnant woman received a drug-induced labor treatment. After the neonate was delivered, the measurement was performed on the weight, length, head circumference, abdomen circumference, and bilateral thigh circumference. OUTCOMES: A female dead neonate was delivered from the vagina of the gravida, showing congenital anus absence. Prenatal ultrasound demonstrated right kidney duplication, hydronephrosis, and right ureteral dilatation. Meanwhile, prenatal MRI showed a cystic cavity, double collecting systems of right kidney, right ureteral dilatation, and right rectum dilatation. In addition, general parameters are as follows: weight: 2280 g; length: 39 cm; head circumference: 26.3 cm; abdomen circumference: 31 cm; right thigh circumference: 17 cm, and left thigh circumference: 18 cm. LESSONS: US combined with MRI can not only provide reliable evidence for fetal CM in the third trimester but also offer crucial information to the pregnant women to establish clinic treatment programs as early as possible.

[Stable Nitrite Accumulation and Phosphorus Removal from High-nitrate and Municipal Wastewaters in a Combined Process of Partial Denitrification and Denitrifying Phosphorus Removal (PD-DPR)].

In this study, a novel process combining partial denitrification (PD, NO3--N→NO2--N) and denitrifying phosphorus removal (DPR) in an anaerobic-anoxic-aerobic sequencing batch reactor (SBR) was developed. By comprehensively controlling the influent C/N ratio, anaerobic drainage ratio, and anoxic duration, the nitrite accumulation and phosphorus removal performance of a system treating high-strength nitrate and municipal wastewaters was investigated. The results showed that, after 140 days, the nitrate-to-nitrite transformation ratio (NTR) was 80.1%, and PO43--P removal efficiency was 97.64%. In the anaerobic stage (180 min), glycogen-accumulating organisms (GAOs) and phosphorus-accumulating organisms (PAOs) efficiently utilized the carbon source in municipal wastewater to enhance intracellular carbon storage. In the anoxic stage (150 min), denitrifying GAOs (DGAOs) and heterotrophic denitrifying bacteria (DOHOs) carried out endogenous and exogenous short-range denitrification, respectively, to achieve stable nitrite accumulation; simultaneously, denitrifying PAOs (DPAOs) carried out denitrifying phosphorus uptake to achieve efficient phosphorus removal. In the aerobic stage (10 min), without initiating ammonia/nitrite oxidation, PAOs absorbed excessive phosphorus, which improved the phosphorus removal performance of the system. The effluent NO2--N/NH4+-N of a ratio of 1.31:1 (close to the theoretical value of ANAMMOX process, 1.32:1), with little PO43--P and COD (0.30 and 12.94 mg·L-1), meets the requirements for deep-level nitrogen removal by coupling with ANAMMOX process.

Accuracy and safety of percutaneous periacetabular screw insertion using screw view model of navigation in acetabular fracture: A case report.

RATIONALE: The purpose of this study was to estimate the efficacy and safety of percutaneous periacetabular screw (PPS) insertion assisted by screw view model of navigation (SVMN) to treat fracture of acetabulum. PATIENT CONCERNS: A 61-year-old male patient was injured in a motorcycle accident, which caused pain, swelling, deformity and limited mobility on his right hip. DIAGNOSES: He was diagnosed with fracture of acetabulum. INTERVENTIONS: We used PPS insertion assisted by SVMN to treat fracture of acetabulum in this patient. OUTCOMES: The follow up lasted 24 months. Totally 2 screws were inserted into anterior and posterior column of acetabulum respectively and both of them displayed grade 0. Compared with the preoperative gap and step of fracture displacement, the postoperative ones were significantly reduced. It took 11.7 minutes for designing the screws, 6.7 minutes for implanting the guide wire, and 45.5 minutes for placing the screws. Intraoperative blood loss was 29 mL and total fluoroscopic time was 4.1 minutes. No clinical complications such as nerve vascular injury, infection and screw loosening were found after the operation. LESSONS: The study indicated that SVMN is favorable to the PPS insertion for acetabular fracture. Our lesson is that the relative position between the acetabular and the patient tracker must be static to ensure the accuracy of the entire system throughout the operation.

Phylogenetic reconstruction and polymorphism analysis of BK virus VP2 gene isolated from renal transplant recipients in China.

BK polyomavirus (BKV) is important pathogen for kidney transplant recipients, as it is frequently re-activated, leading to nephropathy. The aim of this study was to investigate the phylogenetic reconstruction and polymorphism of the VP2 gene in BKV isolated from Chinese kidney transplant recipients. Phylogenetic analysis was carried out in the VP2 region from 135 BKV-positive samples and 28 reference strains retrieved from GenBank. The unweighted pair-group method with arithmetic mean (UPGMA) grouped all strains into subtypes, but failed to subdivide strains into subgroups. Among the plasma and urine samples, all plasma (23/23) and 82 urine samples (82/95) were identified to contain subtype I; the other 10 urine samples contained subtype IV. A 86-bp fragment was identified as a highly conserved sequence. Following alignment with 36 published BKV sequences from China, 92 sites of polymorphism were identified, including 11 single nucleotide polymorphisms (SNPs) prevalent in Chinese individuals and 30 SNPs that were specific to the two predominant subtypes I and IV. The limitations of the VP2 gene segment in subgrouping were confirmed by phylogenetic analysis. The conserved sequence and polymorphism identified in this study may be helpful in the detection and genotyping of BKV.