Dorsal intramedullary spinal epidermoid cysts: Report of two cases and review of literature

Intramedullary epidermoid cysts of the spinal cord are rare tumors, especially those not associated with spinal dysraphism. About 50 cases have been reported in the literature. Of these, only seven cases have had magnetic resonance imaging (MRI) studies. We report two cases of spinal intramedullary epidermoid cysts with MR imaging. Both were not associated with spina bifida. In one patient, the tumor was located at D4 vertebral level; while in the other, within the conus medullaris. The clinical features, MRI characteristics and surgical treatment of intramedullary epidermoid cyst are presented with relevant review of the literature.     

Solitary ileocolic arteriovenous malformation: spongostan and silk therapeutic embolisation.

A debilitated patient with liver cirrhosis and poor haemostasis had a severe lower gastrointestinal haemorrhage. A superior mesenteric arteriogram revealed an early persistent and promiment draining vein in the ileocolic artery. Two fragments of Spongostan and silk were used to embolise the bleeding artery and the haemorhage ceased immediately. No infarction of the embolised area was observed and the bleeding was controlled.     

Patterns of dysphoria in a Puerto Rican urban community.

This study was undertaken to explore the prevalence of perceived dysphoria in a poor, urban, predominantly Puerto Rican community. A cross-sectional sample of 704 adult respondents were asked a single validated question, with a five-item Likert scale response, about their level of perceived dysphoria. Chi-squared analysis and Spearman''s correlation coefficients were used to assess the association of level of dysphoria with social characteristics, barriers to health care, health status, and substance use. Linear regression modeling was used to control for confounding variables. Twenty percent of the respondents were dysphoric. Respondents with no health insurance or no source of health care were least likely to be dysphoric. Persons who perceived distance to the hospital and the doctor, and understanding language of the doctor and office staff as barriers to care were more likely to be dysphoric. Ethnicity was not correlated with level of perceived dysphoria; however, age, gender, and health status were found to be associated with level of dysphoria after controlling for other correlated variables. These results indicate that the psychological needs of communities need to be understood and interventions that are appropriate for the population need to be devised.     

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??Respiratory infections??especially respiratory viral infections??are common diseases in children. Although most respiratory viral infection diseases are self-limiting??some children may be hospitalized or even life-threatened due to severe viral lower respiratory tract infection. With the progress of virology research??new and effective antiviral drugs have been developed. Thus??the study focuses on the therapeutic progress of respiratory viral infections so as to improve the treatment for common respiratory viral infections in children.     

儿童先天代谢异常伴发的肥厚型心肌病

儿童先天代谢异常是导致肥厚型心肌病（HCM）的重要病因, 掌握每种疾病的特征性表现有助于正确的诊断及鉴别诊断。多数先天代谢异常伴发HCM属于常染色体隐性遗传,少数为常染色体显性遗传X连锁遗传方式,部分线粒体病呈母系遗传。常规心电图、超声心动图等心脏检查即可以为部分疾病的基础病因找到诊断线索。随着酶替代疗法等新的治疗方法的不断进步,加强心脏评估,恰当地针对原发病治疗,多学科协同合作将为越来越多的患者生存提供可能。     

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??Objective??To investigate the clinical features and risk factors of multidrug-resistant bloodstream infection in children with acute leukemia. Methods??The clinical data of 121 blood culture-positive patients with acute leukemia admitted from January 1??2013 to September 30??2018 to Department of Pediatrics??Zhujiang Hospital of Southern Medical University were analyzed retrospectively. Results??Of the 121 patients with acute leukemia infected with bacterial bloodstream??55 were in the multidrug-resistant??MDR?? group and 66 in the non-multidrug-resistant??non-MDR?? group. There were 31 gram-positive bacteria in the MDR group. The top three strains were coagulase-negative Staphylococci??Staphylococcus aureus and Streptococcus mutans. Escherichia coli was the main strain of gram-negative bacteria. Logistic analysis suggested that MDR bloodstream infection was more likely to occur in the patiens with AML??P??0.038??OR 2.505??95%CI 1.036—6.058?? and at induction chemotherapy stage??P??0.038??OR 2.226??95%CI 1.045—4.774??. Other high-risk factors included neutropenic dysplasia ??7 d before fever??P??0.003??OR 3.36??95%CI 1.520—7.428????hemoglobin ??70 g/L??P??0.122??OR 1.897??95%CI 0.842—4.274????and platelet??20 g/L??P??0.005??OR 2.995??95%CI 1.388—6.464??. The fever duration and antibiotic course in the MDR group were longer than those in the non-MDR group??and the procalcitoni and C-reactive protein were higher in the MDR group. The empirical treatment of the MDR group was less effective??and the transfer rate for ICU and mortality rate were higher. Conclusion??AML??induction chemotherapy??neutrophil deficiency time before fever ??7 days ??hemoglobin??70 g/L and platelet??20×109/L are risk factors for MDR bloodstream infection. The inflammation response is severe MDR bloodstream infections??which may result in longer anti-infective treatments and a worse prognosis.