Current Issue

2024 Vol.9 No.2 Published:30 April 2024

Original Articles

Analysis of clinical and imaging features of abscess and non-abscess cervical infectious masses in children Fan Meng, Yin Xuntao, Liu Guangming, Hu Yuelin 2024, 9 (2):  1-6.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.001 Abstract ( 74)    PDF (1412KB) ( 100 )    Objective To analyze the clinical and imaging features of the children patients with abscess and non-abscess cervical infectious masses, and compare the differences of diagnosis, treatment and prognosis between the two groups. Method A total of 71 cases of neck infection in children in the Women and Children's Medical Center of Guangzhou Medical University from January 2016 to August 2023 were collected, and they were divided into abscess group (49 cases) and non-abscess group (22 cases) according to the presence or absence of abscess formation.The clinical and imaging characteristics, therapeutic methods and prognosis effects between the two groups were analyzed. Result Among the children with abscess, 31 had fever and 42 had elevated C-reactive protein（CRP）. In 49 cases, the masses were palpable, the texture of the masses was soft in 21 cases, the mobility of the masses was poor in 41 cases, the skin temperature was increased in 18 cases, and the boundaries were blurred in 36 cases. 10 cases involved three or more neck spaces. Among the children with non-abscess, 6 had fever and 9 had elevated CRP. There were palpable neck masses in 19 cases, tough masses in 10 cases, poor mobility in 16 cases, increased skin temperature in 5 cases, and blurred borders in 8 cases. 10 cases involved three or more neck spaces. There were statistically significant differences in clinical manifestations, laboratory parameters and imaging features between the abscess group and the non-abscess group in terms of whether the mass was palpable (P=0.008), the texture of the mass (P=0.027), the activity (P=0.031), the skin temperature (P=0.022), the CRP level(P<0.001), and the lesion boundary(P=0.003). The common causes of neck infection in children patients are piriform fossa fistula, lymphadenitis, and lymphatic malformations. The results of surgical treatment showed that the incidence of postoperative complications was lower in the abscess group (4.1%) and non-abscess group (9.1%). Conclusion Children with abscess neck infection differed significantly from those non-abscess types in terms of clinical and imaging features, and contrast-enhanced, CT or MRI provides an important reference for the diagnosis, differential diagnosis and selection of clinical treatment methods for neck infection.

MALDI-TOF MS technique was used to analyze the bacterial community characteristics of mycobacterium contamination in liquid culture tubes Lan Jihui, Tang Liusheng, Huang Kui, Liu Aimei, Dong Jie 2024, 9 (2):  7-10.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.002 Abstract ( 63)    PDF (859KB) ( 73 )    Objective To understand the characteristics of contaminated bacteria in liquid culture of mycobacterium, analyze the causes of contamination, and find ways to reduce pollution. Method Collect sputum and bronchoalveolar lavage fluid samples from the Guangxi Zhuang Autonomous Region Chest Hospital between May 10, 2023,and August 25, 2023 for liquid culture of Mycobacterium.Using MALDI-TOF MS technology to identify contaminated bacteria produced by liquid culture of Mycobacterium, classify the identified strains statistically, and analyze the microbial community characteristics of contaminated bacteria. Result A total of 864 Mycobacteria were cultured in 6090 respiratory tract samples, the positive rate was 14.19% (864/6090), and the contamination rate was 1.17% (71/6090). The main polluting bacteria were Bacillus and Aspergillus, accounting for 31.08%(23/74) and 24.32%(18/74), respectively. Among the 1429 cases of lavage, 279 cases of mycobacterium were cultured, the positive rate was 19.52% (279/1429), and the pollution was 13 cases, contamination rate was 0.91% (13/1429). In 4661 sputum samples, 585 strains of mycobacterium were cultured. The culture positive rate was 12.55% (585/4661) and the pollution was 58 cases,contamination rate was 1.24% (58/4661). The positive rate between the two specimens exhibited a statistically significant difference (χ2= 43.68, P< 0.05), while no statistically significant difference was observed in the contamination rate (χ2= 1.06, P>0.05). Conclusion The contamination microbial community generated during liquid culture of Mycobacterium is complex, mainly composed of Bacillus and Aspergillus. Therefore, it is necessary to standardize the collection and transportation of specimens, and adopt effective pre-treatment methods to reduce the contamination rate of liquid culture.

SARS-CoV-2-associated acute necrotizing encephalopathy in children: Clinical, imaging and prognosis features Liu Shuyi, Liang Yongyi, Gao Wenjing, Zhang Xiaochun, Wu Xueyi, He Linchao, Chen Chengyan, Zhong Renjia, Hu Yuelin 2024, 9 (2):  11-17.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.003 Abstract ( 81)    PDF (2954KB) ( 84 )    Objective To improve the diagnosis and treatment of SARS-CoV-2 associated necrotizing encephalopathy (ANE) of children by analyzing the clinical characteristics, imaging manifestations,and follow-up prognosis of 10 cases of children. Method The clinical and imaging data of 10 children with SARS-CoV-2 associated ANE diagnosed by Guangzhou Medical University Affiliated Women and Children's Medical Center from December 2022 to January 2023 were retrospectively collected. The clinical manifestations, laboratory indicators, treatment process and brain CT or MRI imaging characteristics were analyzed, and the surviving children were followed up for half a year and determine the prognosis. Result Out of 10 pediatric patients, 8 died and 2 survived. Fever was the first symptom in 9 patients, vomiting was the first symptom in 1 patient, and convulsions followed in 5 patients. Eight died children developed coma upon admission, with a median time from symptom onset to coma of 2 days. The Glasgow coma scale (GCS) scores upon admission were severe for 8 died cases, and the acute necrotizing encephalopathy severity scale (ANE-SS) indicated high risk. While the two surviving patients did not present symptoms of coma, with admission GCS ranging from mild to moderate, and ANE-SS indicated low to moderate risk. Laboratory indicators showed that among the dead children, 7 had elevated alanine aminotransferase upon admission, 8 had elevated alanine aminotransferase, and 7 had concomitant pulmonary infections. Among the surviving children, 1 case had normal alanine aminotransferase and glutamic oxalacetic transaminase, while the other case had elevated glutamic oxalacetic transaminase and normal alanine aminotransferase. No pulmonary infection was found in the two surving cases. All cases involved the thalamus and brainstem, with additional involvement of the basal ganglia, periventricular white matter, bilateral frontal and parietal lobes, and cerebellum. The imaging findings resembled those of ANE caused by other sources of infection, showing multifocal symmetric changes on CT and MRI. CT revealed areas of low density, with some showing signs of hemorrhage. Enhanced MRI scans demonstrated lesion enhancement, and diffusion-weighted imaging sequences indicated restricted diffusion. In patients with a poor prognosis, follow-up contrast-enhanced MRI did not show enhancement in the brain vessels, while in those with a favorable outcome, lesions gradually decreased and disappeared. Conclusions Children with acute necrotizing encephalopathy caused by SARS-CoV-2 infection should be identified in time and actively treated. CT and MRI can show symmetrical lesions, while MRI is more sensitive to early onset.

Value of pleural effusion exosomes miR-506-3p combined with adenosine deaminase test in the early diagnosis and prognostic evaluation of tuberculous pleuritis Zhang Yinwen, Cao Xinchao, Xie Rongjing 2024, 9 (2):  18-23.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.004 Abstract ( 55)    PDF (1897KB) ( 86 )    Objective To evaluate the value of pleural fluid exosome miR-506-3p combined with adenosine deaminase (ADA) in the early diagnosis and prognosis of tuberculous pleurisy. Method Ninety patients with tuberculous pleurisy admitted to Cangzhou People's Hospital from August 2021 to March 2023 were selected as the tuberculosis group, and 50 patients with non-tuberculous pleurisy (parapneumonic pleural effusion, malignant pleural effusion, etc.) admitted to our hospital during the same period were selected as the non-tuberculosis group. The clinical data and the levels of exosomes miR-506-3p and ADA in pleural fluid were compared between the two groups, and the risk factors affecting the occurrence of tuberculous pleurisy were analyzed by multivariate Logistic regression.According to the prognosis of patients after 3 months of treatment, the tuberculosis group was divided into a good prognosis group and a poor prognosis group. The levels of exosomes miR-506-3p and ADA in pleural fluid of the two groups were compared, and the correlation between the two groups was analyzed by Pearson, and the ROC curve was drawn. To analyze the value of pleural fluid exosome miR-506-3p and ADA levels and their combination in predicting the occurrence and prognosis of tuberculous pleurisy. Result ADA level in pleural fluid in TB group was higher than that in non-TB group, and exosome miR-506-3p in pleural fluid was lower than that in non-TB group (P<0.05). Multivariate Logistic regression analysis showed that ADA[OR=1.205 (95%CI 1.105-1.313)] was a risk factor for tuberculous pleurisy(P<0.05). The expression of exosome miR-506-3p [β=0.320 (95%CI 0.158-0.658)] was a protective factor in the occurrence of tuberculous pleurisy(P<0.05). ADA of pleural fluid in poor prognosis group was higher than that in good prognosis group, and exosome miR-506-3p of pleural fluid was lower than that in good prognosis group (P<0.05). Drawing ROC curve found that, The AUC of pleural fluid ADA, exosome miR-506-3p and their combination for predicting the occurrence of tuberculous pleurisy were 0.729 (95%CI 0.640-0.818), 0.810 (95%CI 0.7388-0.883), 0.874 (95%CI 0.818-0.930). The AUC of pleural fluid ADA, exosome miR-506-3p and their combination in predicting the poor prognosis of patients with tuberculous pleurisy were 0.892 (95%CI 0.806-0.978), 0.924 (95%CI 0.868-0.981), 0.942 (95%CI 0.875-1.000). Pearson correlation showed that ADA in pleura was negatively correlated with exosome miR-506-3p (r=-0.335, P=0.001). Conclusion In patients with tuberculous pleurisy, the expression of pleural exosomes miR-506-3p is low and ADA is high, and the two are negatively correlated, and the combination of miR-506-3p and ADA can effectively predict the occurrence of poor prognosis in patients with tuberculous pleurisy.

Distribution of pathogenic bacteria in patients with ventilator-associated pneumonia and detection of serum miR-101-3p and STC1 Yu Chao, Shao Qiang, Chen Li, Huo Qianwen 2024, 9 (2):  24-28.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.005 Abstract ( 54)    PDF (1032KB) ( 65 )    Objective To investigate the distribution of pathogenic bacteria in patients with ventilator-associated pneumonia (VAP) and the clinical significance of detecting the expression levels of serum microRNA-101-3p (miR-101-3p) and stanniocalcin 1 (STC1). Method From January 2020 to April 2023, 121 patients who underwent mechanical ventilation treatment and developed VAP in our hospital were collected as the VAP group, 87 patients who did not develop VAP were regarded as the non VAP group, and 83 healthy individuals were collected as the control group. Lower respiratory secretions were collected from patients in the VAP group for identification of pathogenic bacteria; Serum STC1, procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and serum miR-101-3p levels were measured in all study subjects. Pearson method was applied to analyze the correlation between serum miR-101-3p, STC1, and inflammatory factors PCT, CRP, and TNF-α; receiver operating characteristic curve (ROC curve) was applied to analyze the diagnostic value of serum miR-101-3p and STC1 for VAP. Result A total of 218 strains of pathogenic bacteria were detected and isolated from 121 VAP patients, of which 124 (56.88%) were Gram negative bacteria, 86 strains (39.45%) were Gram positive bacteria, and 8 strains (3.67%) were fungi; the serum levels of miR-101-3p, PCT, CRP, and TNF-α in the VAP group were obviously higher than those in the non VAP group and control group (P< 0.05), while the level of STC1 was obviously lower than that in the non VAP group and control group (P<0.05); the serum miR-101-3p level in VAP patients were positively correlated with PCT, CRP, and TNF-α(P<0.05), while STC1 level were negatively correlated with PCT, CRP, and TNF-α (P<0.05); ROC curve showed that the area under the curve (AUC) of serum miR-101-3p and STC1 alone and in combination for diagnosis of VAP patients were 0.766, 0.750, and 0.841, respectively, the combined diagnostic value was higher than that of the two alone (Z combination-miR-101-3p=2.275, P=0.023, Z combination-STC1=2.856, P=0.004). Conclusion The patients with VAP were predominantly infected with Gram negative bacteria, and the serum miR-101-3p is highly expressed, while STC1 is low expressed. The combination of serum miR-101-3p and STC1 has certain diagnostic value for the occurrence of VAP.

Analysis of pathological and clinical characteristics and factors affecting postoperative complications in surgical patients with non-small cell lung cancer with HIV infection/AIDS Wang Ning, Li Gang, Gong Sheng, Song Yijie, Li Dan, Liu Yu, Tang Jing, Chen Zhaoqiong, Jiang Liangshuang, Yao Xiaojun 2024, 9 (2):  29-33.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.006 Abstract ( 69)    PDF (867KB) ( 64 )    Objective To analyse the influencing factors of pathological and clinical characteristics and postoperative complications in patients with non-small cell lung cancer with HIV infection/AIDS. Method In this study, the pathological and clinical data of NSCLC patients with HIV infection/AIDS who underwent surgery in the Thoracic Surgery Department of Chengdu Public Health Clinical Medical Center from September 2018 to December 2022 and the pathological and clinical characteristics and risk factors of postoperative complications were analyzed. Result A total of 50 patients were included in this study, with a mean age of (56.86±8.89) years, of whom 74.00% were male and 26.00% were female. Adenocarcinoma accounted for 72.00%, and squamous carcinoma accounted for 28.00%. 29 patients underwent genetic testing and PD-L1 protein testing, and the mutation rate of EGFR was 62.06%, the mutation rate of KRAS was 17.24%, the mutation rate of BRAF was 6.90% and the mutation rate of ALK was 3.45%, and the positive rate of PD-L1 protein testing was 20.69% (6/29), and the rate of postoperative complications was 38.00% (19/50). including 14 cases of lung infection, 2 cases of pulmonary atelectasis, 1 case of pyothorax, and 2 cases of coeliac chest. The duration of preoperative antiretroviral therapy ≤4 weeks, HIV load ≥40×103 copy/L, and CD4+T lymphocyte count <200×106/L were suggested to be independent risk factors for postoperative complications by multifactorial logistic regression analysis (P<0.05). Conclusion Maintaining a high CD4+T lymphocyte count and low HIV load through effective antiretroviral, it is effective in reducing postoperative complications of surgical treatment in patients with NSCLC combined with HIV infection/AIDS.

Identification of membrane proteins in Chinese hamster ovary cell using Orbitrap fusion lumos mass spectrometers based on non-label technique Liu Yawen, Liang Xiongshun, Hu Xuqiao, Liu Xiaoqian, Xu Wanna, Hong Wenxu 2024, 9 (2):  34-40.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.007 Abstract ( 56)    PDF (1283KB) ( 126 )    Objective To explore the method of identifying the whole proteome and membrane protein of Chinese hamster ovary (CHO) cells by using the Orbitrap fusion lumos mass spectrometer based on label-free technique,and evaluate its application effect. It provides the methodological basis for studying the pathogenesis of membrane protein-related infectious diseases. Method CHO cells were cultured, and then the whole protein and membrane protein of the cells in the logarithmic growth phase were extracted, enriched and enzymatically hydrolyzed. The peptides were identified by HPLC-Orbitrap fusion lumos three in mass spectrometer. Maxquant software and Uniprot database were used for database search and identification. Finally, the identified membrane proteins were classified by GO function. Result A total of 14 300 peptide segments were detected in the whole proteome, and 2708 proteins were found in the database search,including 2002 credible proteins(FDR<1% and unique peptide>1); A total of 13 179 peptide segments were detected in the membrane proteome, and 2594 proteins were found in the database search,including 1873 credible proteins. Among the top 20 proteins in the identified total protein and membrane protein groups, there are 4 membrane related proteins in the total protein group, accounting for 20%; There are 10 membrane related proteins in the membrane proteome, accounting for 50%. In the membrane protein components. GO function classification shows that molecular function is mainly related to binding and catalytic activity, while in biological processes, it mainly involves cellular processes, metabolic processes. Conclusion The membrane-associated proteins in the membrane protein group were significantly higher than those in the whole protein group,and the application of Orbitrap fusion lumos analysis technology based on label-free technique is an effective method for identifying cell membrane proteins.

The effect analysis of thoracoscopic minimally invasive surgery training based on Kirkpatrick's four-level training evaluation model Gu Yuhui, Zheng Tian, Jin Yongwei, Altai, Che Yong, Ma Binxi 2024, 9 (2):  41-45.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.008 Abstract ( 127)    PDF (1012KB) ( 160 )    Objective To explore the effect of minimally invasive thoracoscopic surgery training based on Kirkpatrick's four-level training model,and to provide a basis for improving related clinical training programs. Method A prospective analysis was conducted on 54 trainees from Central Asian countries who participated in the training of tuberculosis minimally invasive thoracoscopic surgery in the Eighth Affiliated Hospital of Xinjiang Medical University from February 2020 to June 2023. A questionnaire survey was conducted before the training, at the end of the training and 3 months after the training. The training results were analyzed by Kirkpatrick's four-level training evaluation model [reaction layer (training satisfaction), learning layer (theoretical assessment score, operation assessment score, overall evaluation), behavior layer (clinical nursing ability score, leadership score, interpersonal relationship and communication score, ethics and legal practice score, professional development score, education and consultation score, critical thinking and scientific research score), outcome layer (Nursing errors and effective complaints)]. Result The evaluation results of the response layer showed that the training satisfaction scores of 54 trainees for the harvest of training, the practicability of training content, the evaluation of training methods, the evaluation of teachers, and the overall evaluation of training were (4.61±0.56), (4.67±0.48), (4.52±0.57), (4.65±0.52), and (4.59±0.53), respectively. The evaluation results of the learning layer showed that the theoretical assessment scores（95.19±2.07）, operation assessment scores（93.22±2.60）and overall evaluation after training scores（97.15±1.55）after training were higher than those before training（82.43±6.56）,（80.98±5.20）and（82.30±6.27）(P<0.05). The evaluation results of the behavior layer showed that the scores of clinical nursing ability（4.37±0.65）, leadership（4.09±0.71）, interpersonal relationship and communication（4.72±0.66）, ethical and legal practice（4.65±0.65）, professional development（4.57±0.72）, education and consultation（4.41±0.71）, critical thinking and scientific research（4.35±0.73） after training were higher than those before training（3.83±0.61）,（3.57±0.50）,（4.02±0.31）,（3.96±0.39）、（3.98±0.36）,（4.02±0.31）and（3.72±0.53）(P<0.05). The evaluation results of the outcome layer showed that there were no medical and nursing errors and effective complaints among 54 trainees since they participated in the training until October 2023. Conclusion It is very important to participate in standardized technical training courses before surgery. The training of thoracoscopic minimally invasive surgery for tuberculosis can effectively improve the clinical practice ability of doctors and nurses. Kirkpatrick four-level training evaluation can effectively verify the effectiveness of the training program.

Diagnostic value of combined detection of lactate dehydrogenase, adenosine deaminase, and soluble growth stimulation expressed gene 2 for tuberculous pleural effusion Li Li, Cheng Yi, Sun Wei 2024, 9 (2):  46-49.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.009 Abstract ( 63)    PDF (990KB) ( 66 )    Objective To investigate the expression levels of lactate dehydrogenase (LDH), adenosine deaminase (ADA), and soluble growth stimulation expressed gene 2 (sST2) in patients with tuberculous pleural effusion and to analyze the diagnostic value of the three combined for tuberculous pleural effusion (TPE). Method From September 2021 to September 2023, 101 patients with pleural effusion who visited Western Theater Command General Hospital were selected. They were grouped into a TPE group of 52 cases and a control group of 49 cases (non tuberculosis infection) based on the presence of tuberculosis infection. General information was collected, pleural effusion was collected from patients through thoracentesis, enzyme colorimetry was applied to detect LDH level, pois colorimetric method was applied to detect ADA level, enzyme linked immunosorbent assay (ELISA) was applied to detect the level of sST2; receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of pleural fluid LDH, ADA, and sST2 for TPE; multivariate Logistic regression was applied to analyze the influencing factors of TPE occurrence. Result LDH, ADA and sST2 levels in pleural fluid were higher in the TPE group than in the control group, and the difference was statistically significant (P<0.05). ROC curve results showed that the AUC of LDH, ADA and sST2 alone and in combination in predicting TPE in patients with pleural effusion was 0.865, 0.867, 0.880, and 0.954, respectively, the combined diagnosis of the three was superior to the individual diagnosis of LDH, ADA, and sST2 (Z=2.981, 2.232, 2.689, P<0.05). Multifactorial Logistic regression analysis showed that LDH, ADA, and sST2 were all influential factors in the development of TPE (P<0.05). Conclusion LDH, ADA, and sST2 levels are increased in patients with tuberculous pleural effusion, and the combination of the three tests has some diagnostic value in tuberculous pleural effusion.

Analysis of serum T lymphocyte expression and risk factors in patients with infection after trauma transfusion Li Xin, Wang Yunyun, Shi Yougui, Chen Qiming 2024, 9 (2):  50-54.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.010 Abstract ( 42)    PDF (2756KB) ( 60 )    Objective To analyze the changes of serum T lymphocytes in patients with infection after trauma blood transfusion and whether it is related to the patient's infection, and briefly analyze the risk factors of infection in such patients, in order to provide reference for infection prevention and whether immune monitoring is needed in such patients. Method 126 trauma blood transfusion cases admitted to Qinghai Provincial Fifth People's Hospital from January 2019 to May 2023 were included. The patients' serum T lymphocyte levels were measured before and after blood transfusion. According to whether the patients were infected, they were divided into infection group (43 cases) and uninfected group (83 cases), the serum T lymphocyte levels of the two groups were compared, and general information such as patient age, gender, trauma type, whether immunosuppressants were used, and red blood cell storage time were collected for single-factor analysis, and statistically significant results were analyzed. The data were included in the Logistic regression analysis model to complete the risk factor analysis of infection after trauma blood transfusion. Result After blood transfusion, the levels of CD3+T lymphocytes, CD4+T lymphocytes, and CD4+/CD8+ in patients were significantly reduced, while CD8+T lymphocytes were significantly increased (P<0.05); in the infection group, the levels of CD3+T lymphocytes, the levels of CD4+T lymphocytes and CD4+/CD8+ were significantly lower than those of the uninfected group, and the levels of CD8+T lymphocytes were significantly higher than those of the uninfected group (P<0.05); in the single-factor analysis of other general data, patients in the infected group had multiple injuries, use the proportion of immunosuppressants, receiving gastrointestinal decontamination treatment, average red blood cell storage time ≥14 days, and the total number of red blood cell transfusion units ≥7 was significantly higher than that of the uninfected group (P<0.05). The rest were smoking, alcohol abuse, age, gender, there was no significant difference in the average platelet storage time, whether combined with diabetes, and the total number of platelet transfusion units (P>0.05). Logistic regression analysis showed that CD8+T lymphocytes elevated, multiple injuries, use of immunosuppressants, and gastrointestinal decontamination treatment, average red blood cell storage time ≥14 days, and total number of red blood cell transfusion units ≥7 are independent risk factors for infection in trauma blood transfusion patients (OR>1, P<0.05), CD3+T lymphocytes, CD4+T lymphocytes, CD4+/CD8+ is a protective factor (OR<1, P<0.05). Conclusion After trauma blood transfusion, it is easy to have an impact on the patient's immune function. Infected patients after trauma blood transfusion have more obvious disorder of T lymphocyte subsets than uninfected patients. Patients with trauma blood transfusion need to pay attention to their immune monitoring to prevent infection.

Application of ultrasound-guided percutaneous lung biopsy in the diagnosis of AIDS related multiple microbial pulmonary infections Nong Yunjie, Huang Xiaogui, Huang Yulan, Nong Hengrong, Pan Yanxi 2024, 9 (2):  55-58.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.011 Abstract ( 53)    PDF (3427KB) ( 97 )    Objective To explore the application value of ultrasound-guided percutaneous lung biopsy(UGPLB) in the diagnosis of AIDS relate multiple microbial pulmonary infections(MMPI). Method The peripheral lung lesions of 257 AIDS patients with suspected MMPI in the Fourth People's Hospital of Nanning were selected to implement UGPLB from August 2012 to August 2023, and the obtained lung lesion samples were subjected to histopathological examination and pathogen detection. Result The success rate of UGPLB was 98.05%(252/257), 203 cases(80.56%) were finally diagnosed as MMPI, including 95 cases (37.70%) of Mycobacterium tuberculosis + fungus mixed infection, 77 cases (30.56%) of Mycobacterium tuberculosis + non-specific bacteria mixed infection, 16 cases (6.35%) of Klebsiella pneumoniae+fungus mixed infection, and 15 cases (5.95%) of Mycobacterium tuberculosis + Rhodococcus equi + fungus mixed infection; 49 cases (19.44%) had single pathogen pulmonary infection. There were 7 cases (2.72%) of complications after puncture, and all of them had mild symptoms. Conclusion The implementation of UGPLB to collect lung lesion specimens for patients with clinically suspected MMPI and peripheral lung lesions revealed by ultrasound has high success rate and low complication rate, helps to improve the diagnosis and differential diagnosis of MMPI.

Case Report

Case report and literature review of 2 patients with HIV infection complicated with pulmonary embolism Li Mei, Yang Honghong, Tang Guangxiao, Liu Qian, Zhang Lyulang 2024, 9 (2):  59-63.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.012 Abstract ( 61)    PDF (2922KB) ( 90 )    Human immunodeficiency virus (HIV) infection is one of the chronic infectious diseases that seriously affect human health. Pulmonary embolism (PE) is a fatal disease caused by the blockage of the main or branches of the pulmonary artery by internal and external emboli. PE is not common in HIV-infected people, but it has attracted attention because of its high mortality rate. In this paper, the clinical data of 2 cases of HIV infection combined with PE were discussed in order to improve the understanding, attention and diagnosis of the disease. The two male patients were all over 40 years old, had a long history of smoking, had regular anti-HIV treatment, and were diagnosed with severe pneumonia and respiratory failure after admission, requiring long-term bed rest. After comprehensive treatment such as anti-infection, symptoms such as wheezing and shortness of breath did not improve significantly, and then chest imaging examination was performed to confirm PE, and comprehensive treatment such as anticoagulation was given. Due to the low immunity of HIV infected persons, they are easy to combine with other opportunistic infections, thus ignoring the typical clinical symptoms of PE chest pain, hemoptysis, and dyspnea, resulting in clinical missed diagnosis and misdiagnosis. Through the review of the case report and related literature in this paper, to improve the clinician's understanding of the disease, for patients with PE high risk factors to be vigilant, timely elimination, early diagnosis, early treatment.

A case report of AIDS complicated with PJP and monkeypox Yang Junyan, Su Na, Xin Xiaoli, Chen Yuhao, Liang Xuan 2024, 9 (2):  64-67.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.013 Abstract ( 69)    PDF (2593KB) ( 113 )    Monkeypox virus (MPXV) -associated pulmonary infection is relatively rare. We report a case of AIDS with pneumocystis jirovecii pneumonia (PJP) and monkeypox. This is a 40-year-old male patient admitted to Shenyang Sixth People's Hospital on October 2023. The patient was diagnosed as HIV positive before admission, with peripheral rash and fever for 2 months, dry cough for 2 weeks. Local exudation of pus and a small amount of bleeding were observed in the rash, surrounded by flush. The absolute count of CD4+ T lymphoeytes was 6.0×106/L,monkeypox virus nucleic acid test was positive. Lung imaging showed diffuse distribution of ground-glass opacity in both lungs, multiple solid nodules with different sizes were observed in the lungs, halo sign and burrs were observed at the edge. Needle biopsy of pulmonary nodules, histopathogenic microorganism test results were positive for monkeypox virus and Pneumocystis jirovecii. The patient was treated with anti-infection, antifungal and cotrimoxazole. Fever and dyspnea continued to worsen, and finally died. In this paper, the clinical features and pulmonary imaging manifestations of HIV co-infection with PJP and monkeypox virus were discussed by reviewing relevant data, in order to improve the understanding.

Review

Research progress on the association between maternal infection in pregnancy and autism in offspring and its mechanism Tian Liyue, Fan Meng, Chen Wenxiong, Wei Jianrui, Yin Xuntao 2024, 9 (2):  68-72.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.014 Abstract ( 65)    PDF (864KB) ( 148 )    Autism spectrum disorder (ASD) affects 1% of the world's population. It is a severe spectrum of neurodevelopmental disorders characterized by social difficulties, language difficulties, and stereotypical behaviors. These characteristics can appear before the age of three and last a lifetime. At present, the pathogenesis of autism has not been determined. Previous studies have shown that its pathogenesis is related to genetics, maternal pregnancy environment and perinatal immune status. In 1970 Stella proposed that maternal rubella virus infection was associated with autism in offspring. In recent years, there have been repeated studies proving that maternal infection during pregnancy is associated with autism in offspring. Fetal neurodevelopment can be affected in a variety of ways during pregnancy, including active infections and maternal immune response to infections. This article reviews some of the reported infectious factors associated with the etiology of autism, especially maternal infections during pregnancy, including bacterial、viral and toxoplasmosis, and further elaborates the mechanisms associated with different infectious diseases in autistic children.

Research on the regulation of exosomes in mosquito-borne flavivirus infection Luo Yao, Huang Yalan, Yang Fan 2024, 9 (2):  73-78.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.015 Abstract ( 70)    PDF (869KB) ( 162 )    Exosomes are extracellular vesicles that are widely present in human body fluids and secreted by eukaryotic cells, with a diameter of about 30-100nm. According to their biogenetic and structural characteristics, exosomes can carry biological information from host cells to other cells, and play an important role in intercellular communication and physiological and pathological reactions. Affected by the global climate and environment, mosquito-borne infectious diseases are gradually posing a threat to the health of more and more people. One of the important pathogens is faviviridae virus, including dengue virus, Zika virus and encephalitis B virus.. Several studies have found that exosomes play a crucial role in the process of flavivirus infection, which may promote the transmission of the virus or activate the host immune response against the virus. In this paper, we summarized the research progress on the regulatory role of exosomes in mosquito-borne flavivirus infection, in order to better understand the interaction between viruses and host cells, so as to develop candidate cell targets for the prevention and control of mosquito-borne infectious diseases.

Progress in diagnosis and treatment of neurosyphilis Wang Qizheng, Zhao Yu, Sheng Qi 2024, 9 (2):  79-83.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.016 Abstract ( 87)    PDF (861KB) ( 96 )    Since the beginning of the 21st century, the incidence rate and prevalence of syphilis have increased year by year worldwide.Due to its unique transmission route, syphilis has become a serious social public health problem. At the same time, the incidence rate of neurosyphilis also continues to set new records. Treponema pallidum has various manifestations of damage to the nervous system, especially in the early stage of infection. If the diagnosis and treatment is not timely, it will cause irreversible damage to the structure and function of the nervous system, and even disability and dementia in serious cases.At present, neurosyphilis can be classified into symptomatic neurosyphilis and asymptomatic neurosyphilis based on the presence of clinical symptoms, or into early neurosyphilis and late neurosyphilis based on the time of infection.The diagnosis of neurosyphilis is mainly based on the results of laboratory examination of cerebrospinal fluid. This article focuses on summarizing the epidemiology, clinical manifestations, diagnosis and treatment progress of neurosyphilis in recent years, in order to improve the diagnosis and treatment skills of clinicians for this disease.

Standards/Guidelines/Consensus

Interpretation of Expert consensus imaging diagnosis of drug-resistant pulmonary tuberculosis Liu Jingzhe, Song Min, Lu Puxuan 2024, 9 (2):  99-103.  DOI: 10.19871/j.cnki.xfcrbzz.2024.02.018 Abstract ( 73)    PDF (4058KB) ( 100 )    Due to its difficulties in diagnosis and treatment and high case fatality rate, drug-resistant pulmonary tuberculosis is identified by the WHO as one of the three major challenges in tuberculosis prevention and control, and it is also a major public health problem.. To this end, the Chinese Professional Committee of Infection and Inflammation Radiology and other institutions, organized more than 40 influential experts at home and abroad engaged in basic research and clinical related of drug-resistant tuberculosis, the Expert consensus on imaging diagnosis of drug-resistant pulmonary tuberculosis was compiled. Expert consensus on imaging diagnosis of drug-resistant tuberculosis is based on the assessment of evidence-based medicine and referring to the graded consensus guidelines on evidence quality and recommendation strength. Recommendation of imaging examination for drug-resistant tuberculosis (recommendation 1-5), including chest X-ray (DR) as the preferred screening method for drug-resistant pulmonary tuberculosis (level of evidence: Ⅲ, strength of recommendation: strong), and a common means of efficacy evaluation (level of evidence: Ⅳ, strength of recommendation: strong). CT is the main means of diagnosis of drug-resistant pulmonary tuberculosis (level of evidence: Ⅳ, strength of recommendation: strong). Based on the analysis of the imaging data of drug-resistant pulmonary tuberculosis, the CT imaging findings of drug-resistant pulmonary tuberculosis were described, including expert consensus indicating the main manifestations and characteristics of single drug resistance (including rifampin resistance), multidrug-resistant pulmonary tuberculosis (MDR-PTB) [including polydrug-resistant pulmonary tuberculosis (PDR-PTB)], and extensive drug-resistant pulmonary tuberculosis(including pre-extensive drug-resistant pulmonary tuberculosis) (recommendations 6-12). At the same time, the expert consensus described the key points of imaging differentiation between drug-resistant pulmonary tuberculosis and non-tuberculosis pulmonary disease, pulmonary aspergillosis and pulmonary cryptococcal disease. It provides a basis for the accurate diagnosis and guidance of clinical imaging of drug-resistant tuberculosis. This article interprets the expert consensus on imaging diagnosis of drug-resistant tuberculosis in order to help clinicians diagnose drug-resistant tuberculosis.