Nedergaardcollier2768

The percentage of PD-1+/CD3+T cell was 3.63%, with AUC 0.842, sensitivity to predict the mortality 96.43% and specificity 59.38%, (P less then 0.000 1). The percentage of PD-1+/CD4+T cell was 4.65%, with AUC 0.847, sensitivity 96.43%, specificity 62.50%，(P less then 0.000 1). The percentage of PD-1+/CD8+T cell was 3.91%, with AUC 0.771, sensitivity 64.29%, specificity 81.25%，(P=0.000 3). TAE684 in vivo -1 expression is an independent risk factor to predict the 28-day mortality in septic patients. Combining the proportions of PD-1+/CD3+, PD-1+/CD4+and PD-1+/CD8+T cells may further enhance the predictive value for death.Objective To provide more options for preoperative localization diagnosis in patients with primary hyperparathyroidism (PHPT), the diagnostic efficacy of parathyroid 4-dimensional computed tomography (4D-CT) in patients with PHPT was evaluated. Methods This was a single-center retrospective study including 57 patients with surgical proved PHPT. #link# All of the patients underwent 4D-CT, 99Tcm -sestamibi parathyroid imaging (MIBI), and ultrasonography (US) preoperatively. The reference standard for correct localization was based on operation reports and pathology confirmation. The patients were grouped according to the preoperative serum calcium levels, tumor diameter, or ectopic lesions (yes/no), respectively. The sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) of 4D-CT, MIBI and US, alone or in combination, were analyzed in total and each subgroup patients. Results Fifty-seven patients (39 women, 18 men; mean age of 56.5 years) were evaluated, including four cases with multi-gland disease and thirteen cases with ectopic parathyroid lesions. In all the patients, similar diagnostic efficacy was found in 4D-CT (AUC 0.943) and MIBI (AUC 0.927), both of which were higher than that of US (AUC 0.847) (P = 0.01 for 4D-CT vs. US; P = 0.04 for MIBI vs. US). In a subset analysis for ectopic quadrants, the diagnostic efficacy of 4D-CT was significantly higher than that of MIBI (P = 0.04) or US (P = 0.01), with the sensitivity of 100%, 69.2%, and 61.5%, and AUC of 0.989, 0.846, and 0.808 for 4D-CT, MIBI and US, respectively. Conclusions 4D-CT has similar diagnostic efficacy for preoperative localization to MIBI in patients with PHPT, and it is superior to MIBI and US in identifying the ectopic parathyroid gland. 4D-CT can be recommended as an alternative preoperative localization method, especially when parathyroid lesions could not be precisely located by US and MIBI.Prone position ventilation (PPV) is an effective treatment for patients with moderate/sever acute respiratory distress syndrome (ARDS), which can improve oxygenation and reduce mortality. Due to the uneven distribution of medical resources in China, the compliance of PPV is quite low. Standardized protocol of PPV is still unavailable in lots of intensive care units. Subgroup of Critical Respiratory Diseases, Chinese Society of Critical Care Medicine, Chinese Medical Association established a standardized protocol.The aim of the present protocol is to improve the standardized application of PPV in China.In recent years, the clinical guidelines for the diagnosis and treatment of rheumatoid arthritis (RA) have been constantly updated. Among the general principles, it is particularly emphasized that, in order to improve the ratio of treat to target(T2T) of RA, doctors and patients should work together to negotiate the details of the guidelines. Therefore, it is important for patients to further understand the disease and clinical guidelines of RA, and to better cooperate with doctors. This study was based on the most concerned issues of RA patients and international standard procedure of guideline study, we organized the working group and introduce the following 16 recommendations constituting the RA patients' practice guidelines.There are a large number of patients with mental and psychological problems in the cardiology department. The purpose of this consensus was issued for cardiologists to improve their ability to identify and deal with mental and psychological problems and the quality of medical services for the patients.The Chinese Invasive Fungal Infection Working Group published the first edition of guidelines for the diagnosis and treatment of IFD in patients with hematological disorders and cancers in 2005, and has been revised several editions thereafter. Recently, new treatments such as targeted therapy have emerged in the field of hematological cancers. These advances are modifying the definition of high-risk IFD, the epidemiology of IFD, and the strategies in IFD diagnosis and treatment. Meanwhile, diagnostic methods of IFD were evaluated in a lot of clinical studies. Therefore, the Chinese Working Group of Invasive Fungal Infections issued the latest Chinese guideline, based on Infectious Diseases Group of the European Organisation for Research and Treatment of Cancer (EORTC-IDG) and the American Mycoses Study Group (MSG) standards, the Infectious Diseases Society of America (IDSA) guidelines and the European Conference on Infections in Leukemia (ECIL) guidelines. The IFD is still classified as Proven, Probable, Possible and Undefined; the management strategies include prophylaxis, empirical antifungal therapy, diagnostic-driven antifungal therapy and targeted anti-fungal therapy. The major revisions include the epidemiology of IFD, in vitro susceptibility tests of anti-fungal drugs, and therapeutic drug concentration monitoring.Objective To investigate the clinical, pathological and genetic characteristics of neonatal alveolar capillary dysplasia with misalignment of the pulmonary veins (ACDMPV). Methods The clinical manifestations, radiographic examinations, pathology and parental genetic analysis of a newborn with FOXF1 variation induced ACDMPV, who was hospitalized in the Department of Neonatology of Shenzhen Children's Hospital in January 2020, were extracted and analyzed. Related literature up to March 2020 with the key words of "Alveolar capillaries dysplasia" "Alveolar capillary dysplasia with misalignment of the pulmonary veins" "FOXF1" in PubMed, CNKI, Wanfang, CQVIP database and Leiden Open Variation database (LOVD) were searched. Results A full-term male newborn （1 hour of age） was admitted due to anal atresia. Surgical repair of anal atresia and omphalocele was performed on the first day of life, and gallbladder absence and Meckel's diverticulum were identified during the operation. Respiratory distress with hypoxemia deluding 28 missense, 10 nonsense, 11 frameshift, 2 deletion, 1 synonymous, and 2 extensions. link2 Only three of the reported 45 cases （24 males, 21 females） were still alive as of the time of this study. Conclusions Typically, ACDMPV is a catastrophic disease in neonatal period with high mortality. Lung biopsy and genetic testing should be considered in infants who present with persistent pulmonary hypertension and refractory hypoxemia, especially when combined with extrapulmonary abnormalities.Objective To explore the clinical characteristics of intellectual developmental disorder with cardiac arrhythmia syndrome (IDDCA) in a family caused by GNB5 gene variation and to review the literature. Methods The clinical and genetic data of an infant with IDDCA, who visited Shenzhen Children's Hospital in September 2018, were collected and analyzed. His parents' and brother's gene analysis was also done by the next-generation sequencing and confirmed by Sanger sequencing. Related literature up to March 2020 was searched in Online Mendelian Inheritance in Man (OMIM), PubMed, CNKI and Wanfang databases with "GNB5" "IDDCA" "LADCI" "intellectual developmental disorder with cardial arrhythmia" "language delay and attention deficit-hyperactivity disorder or cognitive impairment with or without cardiac arrhythmia" as the key words. The related papers were retrieved and analyzed to summarize the clinical and genetic characteristics of this disorder. link3 Results The proband was an 11-month-old boy who presented with men) had seizures, 79% (23/29) developed language delay and 62%（18/29） had sinus node dysfunction. Genetic tests showed that 4 patients from 3 families had complex heterozygous variation, and 25 patients (86%) from 12 families had homozygous variation. Seventeen patients from 8 families were consanguineous. Among the total 12 variations, there were 4 nonsense, 3 frameshift, 2 missense and 2 shear mutations, and 1 shear disorder caused by synonymous mutation. Conclusions IDDCA caused by GNB5 gene variations mainly manifests as general developmental delay or severe mental retardation, and sinus node dysfunction. GNB5 associated syndromes have phenotypic heterogeneity and are inherited in an autosomal recessive manner.Objective To investigate the efficacy and feasibility of transthoracic implantation of permanent left atrial and left ventricular dual-chamber pacemaker for synchronous treatment of cardiac dysfunction due to idiopathic complete left bundle branch block (CLBBB) in children. Methods The clinical data of five children with cardiac dysfunction due to idiopathic CLBBB and accepting implantation of permanent left atrial and left ventricular epicardial dual chamber pacemaker from January 2015 to July 2019 at the Pediatric Cardiologic Department of the First Hospital of Tsinghua University were analyzed retrospectively. The effects of pacemaker implantation on patients' cardiac function and cardiac synchrony were evaluated by echocardiogram. Results Among 5 patients, 2 were males and 3 females. At the time of pacemaker implantation, the age of these patients was 0.5-5.7 years, the left ventricle ejection fraction (LVEF) was 29%-46%, the left ventricle end stage of diastolic diameter was 30-53 mm and the mean Z score-7.7%--13.8% to -13.5%--20.3%. Conclusion Cardiac dysfunction due to CLBBB in children can be treated with transthoracic implantation of permanent epicardial left atrial and left ventricular dual chamber pacemaker which can substitute three chamber pacemaker to achieve the effects of synchronous therapy that lead to reversion and normalization of cardiac function.Objective To explore the effectiveness and safety of holmium laser treatment via flexible bronchoscopy in children with tracheobronchial tuberculosis (TBTB). Methods The clinical data of 40 children with TBTB admitted in Qilu Children's Hospital of Shandong University from February 2016 to June 2019 were retrospectively analyzed. According to the treatment approach, they were divided into conventional treatment group (20 cases) and holmium laser treatment group (20 cases). The sex, age, course of disease and lesion location before treatment, and the time till relief of atelectasis and airway obstruction after treatment were compared between the two groups with t test and χ2 test. Results Among the 40 cases, 24 were males and 16 females, and 35 had lymph node fistula (87.5%) and 5 had granulation proliferation (12.5%). There was no statistically significamt difference between the conventional group and laser group in sex (male ratio 50%（10/20） vs. 75%（15/20）, χ2=2.66, P=0.10), age （(3.2±2.2） years vs. （2.2±1.8） years, t=1.