Advances in diagnosis and treatment of non-neoplastic Epstein-Barr virus infection-related diseases in children / 国际儿科学杂志

The infection rate of Epstein-Barr virus(EBV)in the population is as high as 95%.It is the first carcinogenic virus found by human beings.Children infected with EBV often cause non-neoplastic diseases, including infectious mononucleosis, chronic active EBV infection and hemophagocytic lymphohistiocytosis.Most of the diseases related to non-neoplastic EBV infection in children are self-limited diseases, and a few of them are complicated with serious complications or develop into neoplastic diseases.The pathogenesis of this kind of disease is complex, the condition is varied, and some children with gene defects have a poor prognosis.Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is an effective treatment for refractory children.At the same time, the condition of some critically ill children is progressing rapidly, so it is very important to create the opportunity of allo-HSCT for such children.

The respiratory sound features of COVID-19 patients fill gaps between clinical data and screening methods

BackgroundThe 2019 novel coronavirus (COVID-19) has continuous outbreaks around the world. Lung is the main organ that be involved. There is a lack of clinical data on the respiratory sounds of COVID-19 infected pneumonia, which includes invaluable information concerning physiology and pathology. The medical resources are insufficient, which are now mainly supplied for the severe patients. The development of a convenient and effective screening method for mild or asymptomatic suspicious patients is highly demanded. MethodsThis is a retrospective case series study. 10 patients with positive results of nucleic acid were enrolled in this study. Lung auscultation was performed by the same physician on admission using a hand-held portable electronic stethoscope delivered in real time via Bluetooth. The recorded audio was exported, and was analyzed by six physicians. Each physician individually described the abnormal breathing sounds that he heard. The results were analyzed in combination with clinical data. Signal analysis was used to quantitatively describe the most common abnormal respiratory sounds. ResultsAll patients were found abnormal breath sounds at least by 3 physicians, and one patient by all physicians. Cackles, asymmetrical vocal resonance and indistinguishable murmurs are the most common abnormal breath sounds. One asymptomatic patient was found vocal resonance, and the result was correspondence with radiographic computed tomography. Signal analysis verified the credibility of the above abnormal breath sounds. ConclusionsThis study describes respiratory sounds of patients with COVID-19, which fills up for the lack of clinical data and provides a simple screening method for suspected patients.

Clinical characteristics of ocular toxocariasis in adults / 中华眼底病杂志

Objective:To observe the clinical characteristics of adult patients with ocular toxoplasmosis (OT).Methods:This study was a retrospective clinical trial. Among the 83 consecutive OT patients diagnosed in the Zhongshan Eye Center of Sun Yat-Sen University, 14 patients (16.9%, adult group) aged ≥18 years were included in the study from January 2017 to December 2019. A total of 14 OT patients (children group) aged less than 18 years who had consecutive visits from July to December 2019 were selected as controls. All patients underwent BCVA, slit lamp microscope, fundus color photography, and B-mode ultrasound examination. Eighteen cases underwent UBM examination, including 6 and 12 cases in the adult group and child group respectively; 23 cases underwent FFA examination, including 12 and 11 cases in the adult group and child group respectively. Snellen visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity in statistics. We compared the two groups of patients' residence (urban or rural), history of contact with dogs and cats, main symptoms, reasons for treatment, course of disease, and clinical and imaging characteristics and so on. For measurement data conforming to normal distribution, t-test was performed for comparison between groups; for Skewness distribution measurement data, rank sum test was performed for comparison between groups. Results:Compared with the adult group and the child group, there was no significant difference in the canine-cat contact history ( Z=2.661, P=0.257) and the time from first diagnosis to diagnosis ( t=-0.186, P=0.351); compared with the children group and the adult group, the patient's living environment was mainly urban, and the course of disease was significantly shorter ( Z=-2.005), and the difference was statistically significant ( P=0.047). The logMAR BCVA of the adult group and the child group were 0.81±1.08 and 2.08±1.30, respectively, and the difference was statistically significant ( Z=-2.811, P=0.004); compared with the child group, the adult group had lighter vitreous opacities, but the difference was statistical significance ( Z=7.847, P=0.048). FFA examination revealed 20 cases of "fern-like" leakage of retinal capillaries. Among them, the adult group and child group were 10 (83.3%, 10/12) and 10 (90.9%, 10/11) cases respectively. Conclusions:Adult patients account for 16.9% of OT patients. Compared with children, adult patients mostly live in towns or cities, have a short course of disease, good vision at first diagnosis, and mild inflammation or hyperplasia of the vitreous cavity. FFA is helpful for the diagnosis of adult OT.

Bronchial Fistula: Rare Complication of Treatment with Anlotinib / 中国肺癌杂志

BACKGROUND@#Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase (RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cases of rare complication of anlotinib-bronchial fistula (BF) during the treatment of lung cancer patients and summarize the possible causes.@*METHODS@#We collected three patients who developed BF due to anlotinib treatment, and conducted a search of Medline and PubMed for medical literature published between 2018 and 2020 using the following search terms: "anlotinib," "lung cancer," and "fistula."@*RESULTS@#Our literature search produced two case reports (three patients) which, in addition to our three patients. We collated the patients' clinical characteristics including demographic information, cancer type, imaging features, treatment received, risk factors for anlotinib related BF, and treatment-related outcomes. The six patients shared some common characteristics: advanced age, male, concurrent infection symptoms, diabetes mellitus (DM), advanced squamous cell and small cell lung cancers, centrally located tumors, tumor measuring ≥5 cm in longest diameter, and newly formed tumor cavitation after multi-line treatment especially after receiving radiotherapy. Fistula types included broncho-pericardial fistula, broncho-pleural fistula, and esophago-tracheobronchial fistula. Six patients all died within 6 months.@*CONCLUSIONS@#Although anlotinib is relatively safe, it is still necessary to pay attention to the occurrence of BF, a rare treatment side effect that threatens the quality of life and overall survival of patients. Anlotinib, therefore, requires selective use and close observation of high-risk patients.

Tricuspid injury in 11 patients after interventional transcatheter closure for perimembranous ventricular septal defect / 中华实用儿科临床杂志

Objective To investigate the characteristics of the newly discovered tricuspid injury during the fol-low -up of the patients with interventional transcatheter closure for perimembranous ventricular septal defect (VSD). Methods A retrospective analysis of clinical data was performed in the successful completion of membranous VSD in-tervention from March 2003 to April 2015,and 11 cases of serious tricuspid injury in children were found during the fol-low -up.Results Among 11 children,10 cases underwent surgery again,and in 7 cases of them with pseudoaneurysm of perimembranous septum,the occluders were deviated toward the right ventricul which caused valvular inadequacy for plate winding closures,extrusion and wear of tricuspid chordae and /or leaflet by right ventricul(RV)disc.Among them,1 case was caused by leaflet fusion tear and tricuspid valve insufficiency;3 cases without pseudoaneurysm were caused by a spindle like RV disc recovery structure protruding into the right ventricle,and then the disc squeezed the tricuspid tendinous cord or leaflet and the right ventricular disc nut wrapped tendon of tricuspid valve finally leading to tricuspid valve insufficiency.There was a small amount of tricuspid regurgitation after surgery;the cardiac size and car-diac function returned to normal.One case did not receive surgery,and at present the right atrium and right ventricle were significantly enlarged,and the activity was limited.Conclusions Tricuspid injury discovered newly after perimem-branous VSD interventional therapy is more common in pseudoaneurysm with large tumor occluding the right ventricular disc resulting in poor formation,and it is important to consider these factors in choosing the size of the occluder and the operation.Long term follow -up mechanism should be established for the treatment of VSD after interventional therapy.

Clinical analysis of 73 pediatric patients with completely atrioventricular conduction block / 中华实用儿科临床杂志

Objective To explore the causes,clinical characteristics and prognosis of children′s completely at-rioventricular block(CAVB).Methods The clinical data of 73 patients with CAVB were analyzed retrospectively from January 2004 to December 201 3 at the Cardiology Department,Nanjing Children′s Hospital Affiliated to Nanjing Medi-cal University.Within those 73 patients,34 patients were male and the others were female,from 3 months old to 1 2.5 years old,the mean age of 6 years.Results There were 21 congenital CAVB patients and 52 acquired CAVB patients with myocarditis undergoing ventricular septal defect (VSD)closure operation.All congenital CAVB patients were re-fractory to drug therapy.Electrocardiogram and echocardiogram were performed in 1 9 cases without clinical symptoms during follow -up,but 2 cases had permanent pacemaker implanted.Among 27 fulminant myocarditis,Adams -Stokes attacks were found in 1 5 cases,3 cases had Adams -Stokes attack in 1 5 cases with sequelae of myocarditis,and 2 out of 6 cases undergoing VSD closure operation had Adams -Stokes attack,and other 4 cases without clinical symptoms were followed up periodically.The acquired CAVB patients were given energy composition and intravenous megavitamin C. The cases with fulminant myocarditis were given adrenal cortical hormone and intravenous gamma globulins simulta-neously.A total of 27 acquired CAVB patients were implanted temporary pacemaker and 5 with permanent pacemaker. Among 52 acquired CAVB patients,31 cases were cured,9 cases were improved,1 1 cases were ineffective,and 1 case died.Conclusions Most congenital CAVB children without clinical symptoms need clinical follow -ups.Myocarditis is a major cause of acquired CAVB.The CAVB prognosis caused by fulminant myocarditis may be related to antimely im-planting the temporary pacemaker timely.Permanent pacemaker should be implanted in patients who have no response to drug therapy with frequent Adams -Stokes or heart failure.

Analysis of CT-occult lung cancer diagnosed by bronchoscopy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the clinicopathological and bronchoscopic characteristics of CT-occult lung cancer.</p><p><b>METHODS</b>Clinical data of 11 patients who were diagnosed with CT-occult lung cancer by bronchoscopy were analyzed retrospectively.</p><p><b>RESULTS</b>Seven out of eleven patients had bloody sputum. The median disease course was 3 months. Nine patients were in stage I or II, among them 5 cases underwent surgery, with a 5-year survival rate of 80.0%. The upper lobes were predilection areas, and all of the 11 patients had direct sign by bronchoscopy. The most common histopathology was squamous cell carcinoma, which had proliferative changes.</p><p><b>CONCLUSIONS</b>Patients with symptoms of persistent bloody sputum should undergo a bronchoscopy to make sure whether there is an occult lung cancer or not, even if the chest CT scan is negative at first visit.</p>

Ethical consideration in academic medical writing / 中华医学科研管理杂志

With the progress of human civilization,the harmonious development of society is gradually realized by different researchers.Medicine,as a science directly serving humans,emphasizes more on humanism than other sciences.Medical research is not only characterized by scientificity and innovativeness,but also by ethicality.More and more biomedical journals are paying attention to issues of ethics.This review discussed the ethical issues in academic medical writing based on the Uniform Requirements for Manuscripts Submitted to Biomedical Journals published by International Committee of Medical Journal Editors (ICMJE) and the discussions by Committee on Publication Ethics (COPE).

Non-thoracoscopic Nuss procedure for correction of pectus excavatum / 中华胸心血管外科杂志

Objective To review our experience in correction of pectus excavatum.by Nuss procedure without thoracoscopic assistance.Methods 412 patients with pectus excavatum were surgically corrected using Nuss technique without thoracoscopic assistance.There were 329 boys and 83 girls with average age of 7 years and 8 months ( range from 2 years and 8 months to 28 yeats and 5 months).The bars were removed after surgery in 102 patients.Results The operation in all patients had been performed successfully without any severe complications The average time of the operation was 40 minutes.The average blood lose during operation was ( 10 ±2) ml.Conclusion Nuss procedure without thoracoscopic assistance is safety and effective.It could be minimize the trauma and shorter operating time.

The expression and its clinical significance of MMP-2 and MMP-9 in non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To investigate the expression and its clinical significance of MMP-2 and MMP-9 in non-small cell lung cancer (NSCLC), so as to provide reference in diagnosis, treatment and determining prognosis of NSCLC.</p><p><b>METHODS</b>MMP-2 and MMP-9 expression was detected in 32 lung cancer tissues, 32 paracancerous lung tissues and 10 benign pulmonary lesion tissues by immunohistochemical method with anti-MMP-2 and anti-MMP-9 antibody.</p><p><b>RESULTS</b>(1)Expression of MMP-2 (90%, 36/40) and MMP-9 (83%, 33/40) in cancer tissues was significantly higher than that in paracancerous tissues (22% and 13%) and benign pulmonary disease tissues (0) (P < 0.01). (2)Expression level of MMP-2 and MMP-9 was significantly related to lymph node metastasis and TNM staging, and histologic classification and differentiation (P < 0.05).</p><p><b>CONCLUSIONS</b>MMP-2 and MMP-9 expression in NSCLC tissue is remarkably higher than that in paracancerous tissues and benign pulmonary tissues. Detaction of MMP-2 and MMP-9 expression in lung cancer tissue might be helpful to determine metastasis, staging of the cancer, and predict the prognosis of patients with NSCLC.</p>