[Clinical analysis of adverse reactions in patients with multidrug-resistant and rifampicin-resistant pulmonary tuberculosis treated with delamanid-containing regimen].

Objective: To explore the characteristics of adverse drug reactions during the 24-week therapy with delamanid-containing regimen for patients with multidrug-resistant and rifampicin-resistant pulmonary tuberculosis (MDR/RR-PTB). Methods: The prospective multicenter study was conducted from June 2020 to June 2023. A total of 608 eligible patients with MDR/RR-PTB were enrolled in 26 tuberculosis medical institutions in China including 364 males and 79 females, aged 39.6(19.0-68.0) years. Patients were treated with chemotherapy regimens containing delamanid. Patients were closely supervised during treatment of medication, and all adverse reactions occurring during treatment were monitored and recorded. The clinical characteristics of adverse reactions were evaluated by descriptive analysis. Chi-square test and multivariate logistic regression were used to analyze the related factors of QTcF interval prolongation (QT corrected with Fridericia's formula). Results: Of the 608 patients enrolled in this study, 325 patients (53.5%) reported 710 adverse events within 24 weeks of treatment. The top 6 most common complications were hematological abnormalities (143 patients, 23.5%), QT prolongation (114 patients, 18.8%), liver toxicity (85 patients, 14.0%), gastrointestinal reaction (41 patients, 6.7%), peripheral neuropathy (25 patients, 4.1%) and mental disorders (21 patients, 3.5%). The prolongation of QT interval mostly occurred in the 12th week after the first dose of medication. Serious adverse reactions occurred in 21 patients (3.5%). There were 7 patients (1.2%) with mental disorders, including 2 patients (0.3%) with severe mental disorders. Conclusions: The safety of dalamanid-based regimen in the staged treatment of MDR/RR-PTB patients was generally good, and the incidence of adverse reactions was similar to that reported in foreign studies. This study found that the incidence of QT interval prolongation in Chinese patients was higher than that reported overseas, suggesting that the monitoring of electrocardiogram should be strengthened when using drugs containing delamanid that may cause QT interval prolongation.

[Etiology and clinical analysis of central nervous system infection caused by Coxsackievirus B5 in severe hand, foot and mouth disease in Qingdao City, 2013-2014].

Objective: To illuminate the gene characteristics and clinical characterization of Coxsackievirus B5 (CV-B5) strains isolated from patients with sevre hand, foot and mouth disease (HFMD) in Qingdao city. Methods: A total of 1 844 patients of HFMD were consecutively admitted to Qingdao Women and Children's Hospital from 2013 to 2014. Information of the study population described above was collected retrospectively. The samples were collected from at least 1 site (throat swab, cerebrospinal fluid), which viral nucleic acid extracted and the entire VP1 gene sequences of CV-B5 isolates were amplified and sequenced, then the homology and phylogeny analysis were conducted by MEGA7.0. The prototype Faulkner strain and other VP1 amino acid sequences were derived from the GenBank database. Results: A total of 8 CV-B5 positive cases were obtained, including 4 males and 4 females; 6 severe hospitalized cases and 2 outpatients. The age of 6 hospitalized patients ranged from 3 to 48 months, with a median of 26 months. For the six inpatients, fever, convulsions vomiting, diarrhea and rash were the main clinical manifestation, and all combined with viral encephalitis. Compared with the prototype strain Faulkner, in the VP1 region,the nucleotide and the amino acid homologies was 77.3%-78.8% and 95.5%-97.0% respectively. Five out of the six severe cases with substitution of serine (S) to asparagine (N) at amino acid site 95 in the VP1 region. The sequences of 8 CV-B5 strains were classified into genogroup D. Conclusion: Hand, foot and mouth disease associated with CV-B5 virus infection can result in nervous system involvement and the main complication was viral encephalitis. The CV-B5 strains associated with severe hand, foot and mouth disease had high nucleotide homology and present a certain regional aggregation.

Application of ultrasound technology in the study of ischemic postconditioning to protect testes from ischemia-reperfusion injury.

This study was designed to investigate the application of ultrasound technology in the study of ischemic postconditioning to protect testes from ischemia-reperfusion injury. Seventy-two big white rabbits were divided into mild ischemic groups (Group A: A0, A1, A2, A3), moderate ischemic groups (Group B: B0, B1, B2, B3) under ultrasound monitor, and control group (N = 8). Groups A0 and B0 received direct perfusion, while the other groups received a different short time filling/stopped filling treatment (15 s/15 s, 30 s/30 s, or 45 s/45 s) three times before complete perfusion. Each group received contrast-enhanced ultrasound before complete filling. At 3 days after perfusion, the testicular tissue was removed for biopsy. The parameters of testicular contrast in pre-reperfusion groups A and B differed significantly from those of their corresponding control groups (P < 0.05). The changes in testis-related pathological indicators in groups A1 and A2 were more significant than those of group A0 (P < 0.05), and changes in group B2 were more obvious than those of group B0 (P < 0.05). There were no statistically significant differences in the comparison of other indicators between the corresponding groups (P > 0.05). Ultrasound technology can help build different degree models of ischemic testes and predict the protective effect of post-ischemic treatment.

Congenital anterior urethral valves and diverticula--analysis of 50 cases.

Fifty patients with anterior urethral valvular obstruction were reviewed. All of them had difficulty in urination, 15 patients had recurrent high fever, 8 patients had features of renal failure, and 5 patients had a reducible swelling at the penoscrotal junction. With voiding cystourethrograph, distension of the proximal urethra was seen in all patients. Diverticula of the urethra could be demonstrated in 15 patients. Eight patients had unilateral, and 2 patients had bilateral vesicoureteral reflux. With intravenous pyelograph, unilateral hydronephrosis was seen in 4 and bilateral hydronephrosis was seen in 19. Excision of the valve and/or diverticulum with primary repair was performed in 29 patients, 28 were cured, 1 died of renal failure 8 years postoperatively. Multi-stage procedures were performed in 7 patients. Transurethral fulguration of the valve was performed in 14 patients. Nine patients were cured, secondary operations were needed in 5 patients.

[The application of modified fetal biophysical profile scoring for prenatal monitoring].

High risk pregnancy 649 cases with gestational age 35 weeks and above were evaluated by modified fetal biophysical profile scoring (BPS) prospectively with B-ultrasonography and electronic fetal monitor mode 115. A total of 1,066 BPS were done. There were 6 fetal deaths with a perinatal mortality rate of 9.24/1000, of whom 4 died from fatal congenital abnormality, 1 was still birth of 35 weeks prematurely delivered, and one was postterm (> 42 weeks) intrauterine death. The corrected perinatal mortality was 3.00/1000. The clinical significance of BPS in predicting fetal hypoxia was discussed. As a predictive method it did help to prevent and treat fetal hypoxic damage at an earlier stage, so that the perinatal mortality rate declined remarkably. The 4 parameters in BPS by ultrasonography were more sensitive for positive predicting than NST.

[Urogenital rhabdomyosarcoma in children: analysis of 39 cases].

From 1967 to 1992, 39 patients with urogenital rhabdomyosarcoma were admitted to our hospital. Of them 30 were male and 8 female and their age ranged from 4 months to 14 years (32 were less than 5 years). Primary tumor was located in bladder or/and prostate in 26, paratesticule 9, vagina 3, and penis 1. Among the 31 patients receiving treatment, 23 were followed up. There were 15 (65%) survivors, including 13 who were free from tumor for over 4 years. The eldest two patients were 20 and 21 years of age. Two patients with vaginal tumor and 4 with bladder tumor preserved their organs with normal function. Biopsy were done only in 8 patients. In recent years, conservative surgery combined with chemotherapy for urogenital rhabdomyosarcoma has been justified.

Atomic scale real-space mapping of holes in YBa2Cu3O(6+δ).

The high-temperature superconductor YBa2Cu3O(6+δ) consists of two main structural units--a bilayer of CuO2 planes that are central to superconductivity and a CuO(2+δ) chain layer. Although the functional role of the planes and chains has long been established, most probes integrate over both, which makes it difficult to distinguish the contribution of each. Here we use electron energy loss spectroscopy to directly resolve the plane and chain contributions to the electronic structure in YBa2Cu3O6 and YBa2Cu3O7. We directly probe the charge transfer of holes from the chains to the planes as a function of oxygen content, and show that the change in orbital occupation of Cu is large in the chain layer but modest in CuO2 planes, with holes in the planes doped primarily into the O 2p states. These results provide direct insight into the local electronic structure and charge transfers in this important high-temperature superconductor.