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Pediatric Investigation 2022年第3期6卷 151-155页

作者： Ran Wang Zhengde Xie Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases Key Laboratory of Major Diseases in ChildrenMinistry of EducationNational Clinical Research Center for Respiratory DiseasesLaboratory of Infection and VirologyBeijing Pediatric Research InstituteBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Research Unit of Critical Infection in Children 2019RU016Chinese Academy of Medical SciencesBeijingChina

ELEVATEDINCIDENCEOFSEVERE ACUTEHEPATITISOFUNKNOWN etiologyINCHILDRENIN2022 As of June 22,2022,920 probable cases of severe acute hepatitis of unknown etiology had been reported in 33 countries.l The numbers of reporte... 详细信息

关键词： etiology acute hepatitis

Acute cholangitis: Does malignant biliary obstruction vs choledocholithiasis etiology change the clinical presentation and outcomes?

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World Journal of Clinical Cases 2023年第29期11卷 6984-6994页

作者： Yung-Kuan Tsou Yi-Tse Su Cheng-Hui Lin Nai-Jen Liu Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalTaoyuan 333TaiwanChina

BACKGROUND Whether clinical outcomes of acute cholangitis(AC)vary by etiology is unclear.AIM To compare outcomes in AC caused by malignant biliary obstruction(MBO)and common bile duct stones(CBDS).METHODS This retrospective study included 516 patients undergoing endoscopic retrograde cholangiopancreatography(ERCP)due to AC caused by MBO(MBO group,n=56)and CBDS(CBDS group,n=460).Clinical and laboratory parameters were compared between the groups.Propensity score matching(PSM)created 55 matched pairs.Confounders used in the PSM analysis were age,sex,time to ERCP,and technical success of ERCP.The primary outcome comparison was 30-d mortality.The secondary outcome comparisons were intensive care unit(ICU)admission rate,length of hospital stay(LOHS),and 30-d readmission rate.RESULTS Compared with the CBDS group,the MBO group had significantly lower body temperature,percentage of abnormal white blood cell counts,and serum levels of aspartate aminotransferase,alanine aminotransferase,and creatinine.Body temperature,percent abnormal white blood cell count,and serum aspartate aminotransferase levels remained significantly lower in the MBO group in the PSM analysis.Platelet count,prothrombin time/international normalized ratio,and serum levels of alkaline phosphatase and total bilirubin were significantly higher in the MBO group.The MBO group had a significantly higher percentage of severe AC(33.9%vs 22.0%,P=0.045)and received ERCP later(median,92.5 h vs 47.4 h,P<0.001).However,the two differences were not found in the PSM analysis.The 30-d mortality(5.4%vs 0.7%,P=0.019),ICU admission rates(12.5%vs 4.8%,P=0.028),30-d readmission rates(23.2%vs 8.0%,P<0.001),and LOHS(median,16.5 d vs 7.0 d,P<0.001)were significantly higher or longer in the MBO group.However,only LOHS remained significant in the PSM analysis.Multivariate analysis revealed that time to ERCP and multiple organ dysfunction were independent factors associated with 30-d mortality.CONCLUSION MBO patients underwent ERCP later and thus had a worse prognosis than CBDS

关键词： Malignant biliary obstruction Common bile duct stones Endoscopic retrograde cholangiopancreatography Acute cholangitis Mortality etiology

etiology and early pathogenesis of malignant testicular germ cell tumors： towards possibilities for preinvasive diagnosis

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Asian Journal of Andrology 2015年第3期17卷 381-393页

作者： Jenny E Elzinga-Tinke Gert R Dohle Leendert HJ Looijenga Department of Urology Subsection of Andrology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands Department of Pathoiogy Laboratory of Experimental Patho-Oncology Erasmus MC Cancer institute University Medical Center Rotterdam Rotterdam The Netherlands

Malignant testicular germ cell tumors （TGCT） are the most frequent cancers in Caucasian males （20-40 years） with an 70% increasing incidence the last 20 years, probably due to combined action of （epi）genetic and （micro）environmental factors. It is expected that TGCT have carcinoma in situ （CIS） as their common precursor, originating from an embryonic germ cell blocked in its maturation process. The overall cure rate of TGCT is more than 90%, however, men surviving TGCT can present long-term side effects of systemic cancer treatment. In contrast, men diagnosed and treated for CIS only continue to live without these long-term side effects. Therefore, early detection of CIS has great health benefits, which will require an informative screening method. This review described the etiology and early pathogenesis of TGCT, as well as the possibilities of early detection and future potential of screening men at risk for TGCT. For screening, a well-defined risk profile based on both genetic and environmental risk factors is needed. Since 2009, several genome wide association studies （GWAS） have been published, reporting on single-nucleotide polymorphisms （SNPs） with significant associations in or near the genes KITLG, SPRY4, BAK1, DMRT1, TERT, ATF71P, HPGDS, MAD1L1, RFWD3, TEX14, and PPMIE, likely to be related to TGCT development. Prenatal, perinatal, and postnatal environmental factors also influence the onset of CIS. A noninvasive early detection method for CIS would be highly beneficial in a clinical setting, for which specific miRNA detection in semen seems to be very promising. Further research is needed to develop a well-defined TGCT risk profile, based on gene-environment interactions, combined with noninvasive detection method for CIS.

关键词： carcinoma in situ etiology environmental exposure semen diagnostics single nucleotide polymorphism testicular germcell tumor pathogenesis

etiology and antimicrobial resistance of community-acquired pneumonia in adult patients in China

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Chinese Medical Journal 2012年第17期125卷 2967-2972页

作者： TAO Li-li HU Bi-jie HE Li-xian WEI Li XIE Hong-mei WANG Bao-qing LI Hua-ying CHEN Xue-hua ZHOU Chun-mei DENG Wei-wu Department of Respiratory Medicine Zhongshan Hospital Fudan University Shanghai 200032. China Department of Respiratory Medicine Taishan Medical University Affiliated Hospital Taian Shandong 271000 China Department of Respiratory Medicine Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background Appropriate antimicrobial therapy of community-acquired pneumonia （CAP） is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens. We performed a prospective observational study of adult with CAP in 36 hospitals in China. Methods Etiological pathogens were isolated in each of the centers, and all of the isolated pathogens were sent to Zhongshan Hospital for antimicrobial susceptibility tests using agar dilution. Results A total of 593 patients were enrolled in this study, and 242 strains of bacteria were isolated from 225 patients. Streptococcus pneumoniae （79/242, 32.6%） was the most frequently isolated pathogen, followed by Haemophilus influenzae （55/242, 22.7%） and Klebsiella pneumoniae （25/242, 10.3%）. Totally 527 patients underwent serological tests for atypical pathogens; Mycoplasma pneumoniae and Chlamydia pneumoniae infections were identified in 205 （38.9%） and 60 （11.4%） patients respectively. Legionella pneumophila infections were identified in 4.0% （13/324） of patients. The non-susceptibility rate of isolated Streptococcus pneumoniae to erythromycin and penicillin was 63.2% and 19.1% respectively. Six patients died from the disease, the 30-day mortality rate was 1.1% （6/533）. Conclusions The top three bacteria responsible for CAP in Chinese adults were Streptococcus pneumonia, Haemophilus influenza and Klebsiella pneumonia. There was also a high prevalence of atypical pathogens and mixed pathogens. The resistance rates of the major isolated pathogens were relatively low except for the high prevalence of macrolide resistance in Streptococcus pneumoniae.

关键词： community-acquired infection pneumonia etiology antimicrobial drug resistance epidemiology

etiology of invasive candidosis agents in Russia： a multicenter epidemiological survey

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Frontiers of Medicine 2018年第1期12卷 84-91页

作者： N.V. Vasilyeva E.R. Raush M.V. Rudneva T.S. Bogomolova A.E. Taraskina Yong Fang Fengmin Zhang N.N. Klimko Department of Medical Microbiology North-Western State Medical University named after L I. Mechnikov St. Petersburg 194291 Russia Kashkin Research Institute of Medical Mycology North-Western State Medical University named after 1.1. Mechnikov St. Petersburg 194291 Russia Sino-Russia Institute of Infection and Immunity Department of Microbiology Harbin Medical University Harbin 150086 China Department of Clinical Mycology Allergy and Immunology North-Western State Medical University named after I.I. Mechnikov St. Petersburg 194291 Russia

A multicenter prospective epidemiological survey on the etiologic agents of invasive candidosis was conducted in Russia in the period of 2012-2014. Samples were collected from 284 patients with invasive candidosis and Candida species isolated by culture. The species were identified by DNA sequencing and MALDI-TOF mass- spectrometry. A total of 322 isolates were recovered, in which 96% of Candida species belonged to six major species, namely, C. albicans （43.2%）, C. parapsilosis （20.2%）, C. glabrata （11.5%）, C. tropicalis （9.6%）, C. krusei （6.2%）, and C. guilliermondii （5.3%）. Most Candida species were isolated from blood samples （83.23%）. Notably, the prevalence rate of C. albicans reduced from 52.38% to 32.79% （2012 vs. 2014）（P = 0.01） whereas that of non-C. albicans increased from 47.62% （2012） to 67.21% （2014）（P〈 0.01）. Species distribution differed among geographical regions; specifically, the prevalence rate of C. albicans as an etiologic agent of invasive candidosis in Siberian Federal region was significantly higher than that in other Federal regions. Results indicated a shift from C. albicans to non-C, albicans. Therefore, a detailed investigation on the contributing factors and appropriate treatment of invasive candidosis is needed.

关键词： prevalence Candida species invasive candidosis nosocomial etiology MALDI-TOF mass-spectrometry candidemia

etiology of newborn hearing impairment in Guangdong province: 10-year experience with screening, diagnosis, and follow-up

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World Journal of Pediatrics 2020年第3期16卷 305-313页

作者： Bi-Xing Fang Jin-Tian Cen Tao Yuan Gen-Di Yin Jing Gu Shu-Qi Zhang Zhi-Cheng Li Yin-Fei Liang Xiang-Li Zeng Division of Otology Department of OtorhinolaryngologyHead and Neck SurgeryThird Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina

Background Hearing impairment is one of the most common birth defects in children.Universal newborn hearing screenings have been performed for 19 years in Guangdong province,China.A screening/diagnosis/intervention system has gradually been put in place.Over the past 10 years,a relatively complete data management system had been established.In the present study,an etiological analysis of newborn cases that failed the initial and follow-up screenings was performed.Methods The nature and degree of hearing impairment in newborns were confirmed by a set of procedures performed at the time of initial hearing screening,rescreening and final hearing diagnosis.Then,multiple examinations were performed to explore the associated etiology.Results Over a period of 10 years,720 children were diagnosed with newborn hearing loss.Among these children,445 (61.81%) children had a clearly identified cause,which included genetic factor(s) (30.56%),secretory otitis media (13.30%),maternal rubella virus infection during pregnancy (5.83%),inner ear malformations (4.86%),maternal human cytomegalovirus infection during pregnancy (2.92%),malformation of the middle ear ossicular chain (2.50%) and auditory neuropathy (1.81%).In addition,275 cases of sensorineural hearing loss of unknown etiology accounted for 38.19% of the children surveyed.Conclusions Long-term follow-up is needed to detect delayed hearing impairment and auditory development in children.The need for long-term follow-up should be taken into account when designing an intervention strategy.Furthermore,the use of the deafness gene chip should further elucidate the etiology of neonatal hearing impairment.

关键词： etiology Hereditary deafness Newborn hearing impairment Tertiary prevention

etiology and therapeutic management of neonatal jaundice in Iran:a systematic review and meta-analysis

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World Journal of Pediatrics 2020年第5期16卷 480-493页

作者： Yadollah Zahed Pasha Shaghayegh Alizadeh-Tabari Ermia Zahed Pasha Mohammad Zamani Non-Communicable Pediatric Diseases Research Center Amirkola Children's HospitalBabol University of Medical SciencesBabolIran Student Research Committee Babol University of Medical SciencesBabolIran Department of Pathology Rohani HospitalBabol University of Medical SciencesBabolIran Cancer Research Center Health Research InstituteBabol University of Medical SciencesBabolIran

Background Jaundice is a life-threatening disorder in the neonates.In the present study,we aimed to assess systematically available evidence on causes and management of jaundice in Iranian newborn patients.Methods We searched the databases of PubMed,Web of Sciences,Scopus and Google Scholar for English articles published since inception until May 2019.A search was also done for Persian articles in Magiran and Scientific Information Database.Studies were evaluated based on predefined criteria by two reviewers.Data analysis was performed by STATA software.Results A total of 33 articles were finally included.The overall pooled prevalence of causes of jaundice among Iranian neonates was as follows:ABO blood groups incompatibility,16.9%[95%confidence interval(CI)10.9-22.8];Rh blood group incompatibility,4%(95%CI 2.5-5.5);ABO and Rh blood groups incompatibility,3.6%(95%CI 0-7.7);glucose6-phosphate dehydrogenase(G6PD)deficiency,6.3%(95%CI 5.1-7.5);infection,6.6%(95%CI 5.2-8.1);hypothyroidism,4.2%(95%CI 0.1-8.3);infant of diabetic mother:2.3%(95%CI 0.1-4.5);unknown,50.7%(95%CI 33.4-68);cephalohematoma,0.6%(95%CI 0.3-0.9).Regarding treatment of icterus,seven and eight articles were found on phototherapy and exchange transfusion,respectively.In five studies,all patients underwent phototherapy,but rate of exchange transfusion use was between 6.6%and 50.9%.Conclusions According to the results,unknown factors were the most common causes of icterus in Iranian neonates,followed by ABO blood groups incompatibility,infections and G6PD deficiency.By the way,phototherapy and exchange transfusion were found as therapeutic choices of neonatal jaundice.

关键词： etiology Jaundice Newborn Systematic review Therapeutics

Efficacy of stepwise mini-incision microdissection testicular sperm extraction for nonobstructive azoospermia with varied etiologies

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Asian Journal of Andrology 2023年第5期25卷 621-626页

作者： Yu-Xiang Zhang Chen-Cheng Yao Yu-Hua Huang Peng Li Er-Lei Zhi Zi-Jue Zhu Jian-Xiong Zhang Fu-Jun Zhao Zheng Li Ru-Hui Tian Department of Andrology The Center for Men's HealthUrologic Medical CenterShanghai Key Laboratory of Reproductive MedicineShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200080China

Stepwise mini-incision microdissection testicular sperm extraction(mTESE)is a procedure that attempts to minimize testicular damage.However,the mini-incision approach may vary in patients with different etiologies.Here,we performed a retrospective analysis of 665 men with nonobstructive azoospermia(NOA)who underwent stepwise mini-incision mTESE(Group 1)and 365 men who underwent standard mTESE(Group 2).The results showed that the operation time(mean±standard deviation)for patients with successful sperm retrieval in Group1(64.0±26.6min)was significantly shorter than that in Group2(80.2±31.3min),with P0.05),even when the etiologies of NOA were taken into consideration.The results of consecutive multivariate logistic regression analysis(odds ratio[0R]:0.57;95%confidence interval[Cl]:0.38-0.87;P=0.009)and receiver operating characteristic(ROC)analysis(area under the ROC curve[AUC]=O.628)showed that preoperative anti-Mullerian hormone(AMH)level in idiopathic NOA patients was a potential predictor for surgical outcomes after initial three small incisions made in the equatorial region without sperm examined under an operating microscope(Steps 2-4).In conclusion,stepwise mini-incision mTESE is a useful technique for NOA patients,with comparable SRR,less surgical invasiveness,and shorter operation time compared with the standard approach.Low AMH levels may predict successful sperm retrieval in idiopathic patients even after a failed initial mini-incision procedure.

关键词： etiology male infertility nonobstructive azoospermia standard mTESE stepwise mini-incision mTESE

Update on Mayer—Rokitansky—Küster—Hauser syndrome

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Frontiers of Medicine 2022年第6期16卷 859-872页

作者： Na Chen Shuang Song Xinmiao Bao Lan Zhu National Clinical Research Center for Obstetric and Gynecologic Diseases Department of Obstetrics and GynecologyState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing100730China Peking Union Medical College M.D.ProgramBeijing100730China

This review presents an update of Mayer—Rokitansky—Küster—Hauser(MRKH)syndrome on its etiologic,clinical,diagnostic,psychological,therapeutic,and reproductive aspects.The etiology of MRKH syndrome remains unclear due to its intrinsic heterogeneity.Nongenetic and genetic causes that may interact during the embryonic development have been proposed with no definitive etiopathogenesis identified.The proportion of concomitant extragenital malformations varies in different studies,and the discrepancies may be explained by ethnic differences.In addition to physical examination and pelvic ultrasound,the performance of pelvic magnetic resonance imaging is crucial in detecting the presence of rudimentary uterine endometrium.MRKH syndrome has long-lasting psychological effects on patients,resulting in low esteem,poor coping strategies,depression,and anxiety symptoms.Providing psychological counseling and peer support to diagnosed patients is recommended.Proper and timely psychological intervention could significantly improve a patient’s outcome.Various nonsurgical and surgical methods have been suggested for treatment of MRKH syndrome.Due to the high success rate and minimal risk of complications,vaginal dilation has been proven to be the first-line therapy.Vaginoplasty is the second-line option for patients experiencing dilation failure.Uterine transplantation and gestational surrogacy are options for women with MRKH syndrome to achieve biological motherhood.

关键词： MRKH(Mayer-Rokitansky-Küster-Hauser)syndrome etiology clinical characteristic diagnosis treatment psychological effect

etiology and clinical features of viral bronchiolitis in infancy

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World Journal of Pediatrics 2017年第4期13卷 293-299页

作者： Andrew Fretzayas Maria Moustaki 3rd Department of Pediatrics Athens UniversitySchool of MedicineAthensGreece

Background:Bronchiolitis is a common lower respiratory tract infection in infancy.The aim of this review is to present the clinical profile of viral bronchiolitis,the different culprit viruses and the disease severity in relation to the viral etiology.Data sources:Databases including PubMed and Google Scholar were searched for articles about the clinical features of bronchiolitis and its viral etiology.The most relevant articles to the scope of this review were analyzed.Results:Currently there are two main definitions for bronchiolitis which are not identical,the European definition and the American one.The most common viral pathogen that causes bronchiolitis is respiratory syncytiai virus which was identified in 1955;now many other viruses have been implicated in the etiology of bronchiolitis such as rhinovirus,adenovirus,metapneumovirus,and bocavirus.Several studies have attempted to investigate the correlation of bronchiolitis severity with the type of detected virus or viruses.However,the results were not consitent.Conclusions:For the time being,the diagnosis of bronchiolitis remains clinical.The isolation of the responsible respiratory pathogens does not seem to confer to the prognosis of the disease severity.

关键词： clinical features etiology viral bronchiolitis