简介：AbstractIntraamniotic infection (IAI) or chorioamnionitis is a common cause of preterm birth and may cause adverse neonatal outcomes, including neonatal pneumonia, respiratory distress, meningitis, sepsis, and death. Maternal morbidities from intraamniotic infection include dysfunctional labor requiring increased intervention, cesarean birth, postpartum uterine atony with hemorrhage, endometritis, peritonitis, sepsis, adult respiratory distress syndrome and, rarely, death. Chorioamnionitis can result from an ascending infection, iatrogenic causes or transplacental passage from maternal blood-borne infections. The clinical findings of chorioamnionitis include maternal fever (≥38 °C), maternal (>100 beats per minute) and/or fetal tachycardia (>160 beats per minute), maternal leukocytosis on complete blood count (>15 000 cells/mm3), and uterine tenderness and/or purulent and/or foul-smelling amniotic fluid. The management of chorioamnionitis mainly includes antibiotic therapy and delivery. Women with previable preterm premature rupture of membranes should be offered realistic counseling from a multidisciplinary approach. The separation of the mother and the fetus to preserve the life of the mother should prioritize delivery methods that result in a living fetus if possible, with appropriate neonatal resuscitation available.

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简介：AbstractPrimary aldosteronism (PA) is a common form of endocrine hypertension. The diagnostic process of PA includes a screening test, confirmatory test, and subtype classification. In this review, we have summarized the latest advances in the diagnosis of PA with regard to screening and confirmatory tests and provided some recommendations to improve clinical practice.

简介：AbstractHarlequin ichthyosis is a severe autosomal recessive skin disorder. Most deaths occur within the first few days after birth, and the survivors still have severe chronic skin disease throughout their lives. Almost all cases were associated with a pathogenic variant of adenosine triphosphate binding cassette transporter, subfamily A, member 12 (ABCA12) gene. We described a case of HI diagnosed by ultrasound examination during the second-trimester and genetic diagnosis reveal two novel heterozygous ABCA12 mutations c.2563-2570delinsGGCAATT, p.(Leu855Glyfs*13), and c.6116delT, p.(Met2039Argfs*8) by the next-generation DNA sequencing, which further enriched our understanding of the pathogenic variation of ABCA12 gene.

简介：AbstractGonorrhea is one of the main sexually transmitted diseases in China. It mainly affects the genitourinary tract, and its clinical manifestations vary from asymptomatic to complicated types. The diagnosis of gonorrhea should be based on the patient’s epidemiological history, clinical manifestations, and laboratory examination results. Treatment should be prompt and standardized and should involve the recommended treatment regimens. Patients should be appropriately followed up after treatment. The antimicrobial resistance of gonococcal isolates has become a severe problem of clinical concern. In order to provide technical guidance of the diagnosis and treatment of gonorrhea for health care workers, the authors developed the guidelines based on the version of 2014, which will be of important in the standardizing medical care of gonorrhea, and further facilitating control and prevention of the disease.

简介：AbstractImportance:There is a high incidence of iron deficiency in children worldwide. Notably, however, while iron deficiency is the most common cause of anemia, little is known about the prevalence and different types of iron deficiency in neuroblastoma patients.Objective:The aim of the present study was to investigate the prevalence of iron deficiency in patients newly diagnosed with neuroblastoma.Methods:A total of 195 newly diagnosed neuroblastoma patients from November 2015 to January 2018 were analyzed retrospectively. The survival analysis was estimated by the Kaplan-Meier method.Results:Of the 195 neuroblastoma patients included in the study, 121 (62.1%) had iron deficiency, 55 (28.2%) had absolute iron deficiency, and 66 (33.9%) had functional iron deficiency. Being aged ≥ 18 months, tumor originating in the abdomen, International Neuroblastoma Risk Group Staging System M, high-risk neuroblastoma, lactate dehydrogenase ≥ 1500 U/L, neuron-specific enolase ≥ 100 U/L, unfavorable histologic category, MYCN amplification, chromosome 1p loss, and bone marrow metastasis were associated with significantly higher rates of functional iron deficiency (P < 0.05).Interpretation:Functional iron deficiency at the time of initial neuroblastoma diagnosis predicted lower event-free survival. Long-term effects of iron supplementation in neuroblastoma patients with different types of iron deficiency need to be further studied.

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简介：AbstractUrticaria is a common dermatological condition that is characterized by wheals and pruritus. Certain types of urticaria can be resistant to treatment, and recurrence is common. These guidelines supplement and improve upon the previous version (published in 2014) of the Guidelines for the Diagnosis and Treatment of Urticaria in China, and incorporate recent research advances in urticaria. These guidelines are suitable for both Chinese adults and children of Han nationality with urticaria. These guidelines update and broaden the definition, pathogenesis, classification, diagnosis, and treatment of urticaria, and serve as a scientific and authoritative reference for the diagnosis and management of urticaria.

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简介：AbstractA pancreatic cystic neoplasm (PCN) is a rare pancreatic disease. Malignant PCNs are usually identified incidentally while evaluating other lesions. However, PCNs are being identified more frequently owing to the increased use of abdominal imaging. Malignant PCNs have complicated and diverse biological behaviors, including various malignant risk factors, diverse molecular features, natural history, and complex pathological classifications. Although many diagnostic methods, such as cross-sectional imaging and endoscopic evaluation, have been developed, malignant PCNs are still difficult to differentiate from benign tumors. On searching for related articles in the recent decade, we found that some molecular biomarkers such as carcinoembryonic antigen could be useful for discriminating between malignant tumors and benign tumors. However, cytopathologic evaluation is the most useful method for differentiating between benign and malignant lesions. Although cytopathologic evaluation has a specificity of 100% for identifying malignancies, its accuracy is often hampered by the low cellularity of PCN cells in the cystic fluid. Herein, we review the progress in the use of cellular and molecular markers for the accurate identification of PCNs.

简介：AbstractPemphigus vulgaris (PV) is a life-threatening autoimmune bullous disease that causes blisters and erosions on the skin and mucous membranes to standardize the diagnosis and treatment of PV, Chinese experts in this field were invited to make recommendations which are presented in this article. Pemphigus vulgaris can be divided into cutaneous mucous type, cutaneous type and mucous mucous dominant type according to the different clinical manifestations. The pathological manifestations of PV are acantholysis above the basal layer. The diagnosis of PV and the assessment of the severity of the disease are made in accordance with the clinical manifestations, histopathological features, immunofluorescence assay results, and detection of pathogenic serum antibodies. The first-line treatment of PV comprises systemic glucocorticoids. Early combination with immunosuppressive agents or rituximab is recommended for moderate and severe PV. Intravenous immunoglobulin administration is recommended for patients being treated with rituximab. Plasma exchange and stem cell transplantation can be performed if necessary. During the course of therapy, the disease activity should be closely monitored, and actions should be taken to prevent adverse reactions.

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简介：AbstractOutbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

简介：AbstractPsoriasis is an immune-mediated chronic, recurrent, systemic inflammatory disease induced by the combination of hereditary and environmental factors. The etiology of psoriasis involves hereditary, immune, environmental, and other factors, and its pathogenesis is considered to involve excessive proliferation of keratinocytes or inflammatory activation of synovial cells and chondrocytes within joints; these processes are caused by an immune response that is mainly mediated by T lymphocytes and various other immune cells. Psoriasis is an incurable disease, and the goal of treatment is to control the progression of disease and maintain long-term efficacy. Treatment protocols should be based on the patients’ conditions. Patients with mild psoriasis can be mainly treated with topical agents, and those with moderate to severe psoriasis can be treated with systemic medications. Targeted biological agents can be appropriately chosen for cases of psoriasis that are resistant to traditional systemic treatment. New drugs and treatments for psoriasis continue to evolve and emerge, and our updated guidelines are designed to deliver new achievements from China and physicians worldwide and to keep pace with global progress on psoriasis research. Compared with the previous two editions, part of contents have been modified and revised in the present guidelines; this will further facilitate standardization and increase the efficiency of the diagnosis and treatment of psoriasis in China, and improve patients’ quality of life.

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简介：AbstractThe gold standard of cancer diagnosis has long been based on histological characteristics. With the rapid advancement of genetic medicine, such standard algorithm of diagnostic approach is facing a challenge. The genetic findings have been changed from being a "supporting character" into the role of a "main character" . More and more disease diagnosis and classification has to be defined by genetic basis. In this article, we focus on the challenges in the field of pediatric oncology. We cited 2 scenarios where genetic information plays a pivotal role in identifying the underlying pathology. The first scenario is that same genetic mutation can lead to variable clinical phenotypes, this includes EWSR1-PATZ1 fusion related neoplasms; BCOR neoplasms; and GATA-2 deficiency related immunodeficiency and myelodysplastic syndrome. Another scenario is relatively more common that is the same clinical and histopathological phenotype with different underlying genotypes. The genotypes actually impact on the treatment response and outcome. We used medulloblastoma as an example. In fact, we can also find similar scenario in many pediatric cancers such as Ewing sarcoma, ependymoma, etc. The essence of this article is to remind clinicians of the rapid development in genetic medicine and it has been reshaping the landscape of the modern disease classification and therapeutic approach. In the near future, it may even lead to a paradigm shift in our disease diagnostic algorithm.