To investigate the clinical characteristics and outcome of neurobrucellosis patients with hearing loss as the major clinical manifestation.

From October 2008 to September 2019, 7 cases of neurobrucellosis with hearing loss in Beijing Ditan hospital, Capital Medical University were selected, and their clinical data including epidemiological history, clinical manifestations, etiological specificity, cerebrospinal fluid analysis, ear examination, pure tone audiometry, imaging findings were analyzed, respectively. Analysis and discussion were performed based on domestic and foreign literature.

Among the 7 neurobrucellosis patients with hearing loss, 5 were male and 2 were female, aged 22-70 years old, with the average age as 39.29 years old. All of the 7 patients had definite epidemiological history, early presentation of typical symptoms of brucellosis: fever, hyperhidrosis, muscle and joint pain, fatigue and headache, etc. Hearing loss was manifested as sensorineural deafness, 2 cases in the early stage, 3 cases in the course of treatment and 2 cases after drug withdrawal. There were 2 cases with unilateral hearing loss and 5 cases with binaural diseases. There were 2 cases with sudden deafness and 5 cases with progressive hearing loss. There were 4 cases with the course of hearing loss < 3 months, whose hearing capabilities were all improved after treatment; there were 3 cases with the course of hearing loss > 3 months but no case occured hearing improvement after treatment. There were 5 cases with mild and moderate deafness, 2 cases with severe and extremely severe deafness. Lumbar puncture showed a slight increase in intracranial pressure, with an average of 197 mmH₂O, elevated white blood cells in cerebrospinal fluid, with an average of 104 cells/μl [monocytes dominated (90.7%)], cerebrospinal fluid protein as 206.1 mg/dl, cerebrospinal fluid sugar as 1.95 mmol/L, cerebrospinal fluid chloride as 118.7 mmol/L.

Hearing loss associated with neurobrucellosis was not rare. Because of its relatively lack of specific clinical manifestations, it was easy to misdiagnose and missed diagnosis. Early detection, diagnosis and treatment could decrease sequelae.

To investigate the clinical characteristics of cases with acquired immunodeficiency syndrome (AIDS) complicated with central nervous system (CNS) treated by neurosurgery.

From January 2012 to December 2018, the clinical data of 62 patients with AIDS and CNS infection were analyzed, retrospectively.

The 62 cases with AIDS and CNS infection who received surgical treatment accounted for 28.4% (62/218) of the AIDS cases with CNS lesions in the Department of Neurosurgery during the same period. The main clinical manifestations were fever, intracranial hypertension, dysfunction, dizziness and epilepsy. There were 32 (51.6%) cases underwent shunt, 11 (17.7%) cases underwent pathological biopsy and 19 (30.6%) cases underwent intracranial space-occupying resection. Among the 62 cases diagnosed by laboratory and postoperative pathology, 33 (53.2%) cases with fungal infection, 1 (1.6%) case with virus infection, 1 case (1.6%) with syphilis granuloma infection, 5 (8.1%) cases with parasitic infection, 8 (12.9%) cases with Mycobacterium tuberculosis infection, 4 (6.5%) cases with bacterial infection, 9 (14.5%) cases with unexplained infections, 1 (1.6%) case with mixed infection. After surgical treatment, 46 (74.2%) cases improved, 14 (22.6%) cases had no improvement, and 2 (3.2%) cases gave up treatment.

The spectrum of pathogenic of AIDS complicated with CNS infection was extensive, the clinical manifestations were fever, intracranial hypertension, dysfunction, dizziness and epilepsy; the incidence of fungal infection was the highest. Surgical intervention could be used as an important mean of diagnosis and treatment of this kind of disease, and the efficiency of diagnosis and treatment could be improved.

To investigate the characteristics and prognosis of Clostridium difficile infection in patients with advance liver cirrhosis.

From January 2018 to May 2019, four cases were diagnosed with Clostridium difficile infection and liver cirrhosis in Beijing Ditan Hospital, Capital Medical University. The diagnosis, treatment and clinical outcome of the four cases were analyzed, respectively and relevant literature were reviewed.

All cases with initial episode with Clostridium difficile infection were advanced liver cirrhosis patients with various complications. A definite diagnosis was performed by fecal detection of Clostridium difficile gluconate dehydrogenase (GDH) combined with toxin enzyme-linked immunosorbent assay. There were 3 cases with fulminant type and 1 case recurred. All 4 cases were treated with vancomycin. Two cases died within one year after onset, among whom one case died within 24 h.

Improving clinical cognition, perfect diagnosis test, timely diagnosis and treatment of Clostridium difficile in patients with liver cirrhosis was essential to reduce the incidence and morbidity.

To analyze the clinical characteristics and prognostic factors of opportunistic infection (OIs) of central nervous system (CNS) in patients with acquired immunodeficiency syndrome (AIDS).

The clinical data of 153 patients with AIDS complicated with CNS OIs were collected from January 2012 to March 2018, the general conditions, clinical manifestations, auxiliary examinations, diagnosis, treatment and prognosis were analyzed, respectively. The patients with AIDS complicated with CNS OIs were divided into death group and survival group according to whether died within half a year. The prognostic factors of these patients were analyzed by multiple factors Logistic regression.

Among the 153 patients with AIDS complicated with CNS OIs, 73 (47.7%) cases were with Cryptococcus neoformans meningeal, 27 (17.6%) cases with unexplained CNS infection, 14 (9.2%) cases with mixed infectious CNS diseases, 12 (7.8%) cases with CMV neurological diseases, 12 (7.8%) cases with Toxoplasma gondii encephalopathy, 9 (5.9%) cases with tuberculous meningeal (brain) inflammation, 5 (3.3%) cases with neurosyphilis, 1 (0.7%) case with herpes simplex virus encephalitis. After treatment for causes and (or) symptoms, 102 (66.7%) patients were with stable condition and 51 patients died. Multivariate Logistic regression analysis showed disturbance of consciousness, decreased muscle strength, peripheral blood CD4⁺ T lymphocyte count < 25 cells/μl, Epstein-Barr virus (EBV) viremia were all independent risk factors associated with mortality of AIDS patients complicated with CNS OIs (P = 0.000, 0.014, 0.012, 0.005).

AIDS complicated with CNS OIs had many diagnostic types, great difficulty in diagnosis and treatment, and high mortality. Severe impairment of CNS function, serious immunodeficiency and EBV viremia were independent risk factors associated with mortality. Early screening to identify the above mentioned high-risk patients were needed. Early detection of CNS OIs and timely targeted treatment could reduce the morbidity and mortality of these patients.

To investigate the clinical value of pattern reversal visual evoked potential (P-VEP) in early diagnosis and assessment of optic nerve injury caused by neurosyphilis.

Total of 21 neurosyphilis patients with abnormal P100 wave latency and with P-VEP examination in Beijing Ditan Hospital, Capital Medical University from January 2016 to December 2019 were collected and the P-VEP results, clinical manifestations, characteristics of cerebrospinal fluid and serum indicators were analyzed, respectively.

Among the 21 patients with abnormal P-VEP, most were male (76%, 16/21). The mean age was (45.0 ± 11.5) years old. There were 17 patients with positive ocular symptoms and 4 patients with negative ocular symptoms. All patients with abnormal P-VEP neurosyphilis had optic nerve damage, whether symptomatic or asymptomatic. The abnormality of P-VEP was mainly manifested as prolonged latency of P100 wave. Of the abnormal eyes of P100 latency [(135.16 ± 22.21) ms] was significantly longer than that of normal eyes [(92.75 ± 8.26) ms], with significant difference (t =-2.813, P = 0.007). Patients with positive ocular symptoms had a longer latency of P100 wave [(137.94 ± 23.12) ms] than patients without ocular symptoms [(120.33 ± 5.50) ms], with significant difference (t = 1.28, P = 0.217). There was no correlation between P100 wave latency and white blood cells (r = 0.349, P = 0.155) and protein (r = 0.240, P = 0.323) of cerebrospinal fluid. The clinical data of 8 reexamined patients were analyzed and the changes of P100 wave latency were not consistent with the biochemical manifestations of serum and cerebrospinal fluid (all P > 0.05). Five of the eyes presented P100 wave absence, which did not improve during 6 months after treatment. P100 wave deletion may indicate that the optic nerve damage was irreversible.

Prolonged latency of P100 wave or absence of waveforms in patients with neurosyphilis may indicate optic nerve damage. The absence of a P100 wave form may indicate severe and irreversible optic nerve damage. Abnormal P-VEP may indicate neurosyphilis optic nerve damage earlier than clinical symptoms. It provides a basis for determining the optic nerve damage and the degree of damage in patients with neurosyphilis.

To investigate the genotype of Orientia tsutsugamushi (O. tsutsugamushi) infection in Zhejiang and Fujian provinces, southeastern China and to analyze the gene variation.

Strains of O. tsutsugamushi were isolated from the blood of 5 scrub typhus patients of febrile phase and then cell culture were carried out. DNA from the infected cells were extracted and full-length 56-kD type-specific antigen (TSA) gene and full-length heat shock protein gene (groESL) were amplified. The gene products were sequenced. Multiple sequence alignment and phylogenetic analyses were conducted by Mega 7.0 software.

Five febrile patients with O. tsutsugamushi infection were confirmed etiologically and five O. tsutsugamushi strains were isolated. The sequence alignment of 56-kD TSA gene and groESL gene showed that 2 among the 5 strains had 100% identity; while other two strains also had 100% identity of these two genes. These two groups were temporarily named Zhejiang-1 and Zhejiang-2. The 56-kDa TSA gene alignment and phylogenetic analysis showed that Zhejiang-1 was closely related to Taiwan-A genotype (98.45%) and Zhejiang-2 was closely related to Gilliam-C genotype (98.50%), but there were obvious variations. The other 1 strain of Wuj/2014 was significantly similar to Taiwan-A genotype (99.94%). Based on 56-kDa TSA gene, the timetree based on the RelTime method showed that Taiwan-A genotype, Zhejiang-1 and especially Zhejiang-2 genotype were later than other prototypes on the divergence time from their ancestors of each genotypic clade. These genotypes or subtypes emerged later in evolutionary process of O. tsutsugamushi.

There may be unrecognized novel O. tsutsugamushi variants among the patients in this study. The relationship between genetic variation and severity of scrub typhus also should be discussed.

To analyze the correlation between liver pathological features and laboratory parameters of chronic hepatitis B (CHB) patients with alanine aminortransferase (ALT) < 2× upper limits of normal (ULN).

Total of 91 patients with CHB of ALT < 2× ULN who underwent liver puncture in the Sencond People’s Hospital of Lanzhou from January 2017 to May 2019 were collected. According to the results of liver penetrating examination, 61 cases with G2 lower were classified as mild inflammation group, and 30 cases with G2 and above were as moderate inflammation group; 69 cases with S2 lower were as no obvious fibrosis group, and 22 cases with S2 or above were as obvious fibrosis group. Two groups of inflammation and fibrosis patients were respectively compared with blood cells (WBC), liver biochemical indicators, international standard ratio (INR), hepatitis B virus marker (HBV M) and HBV DNA through comparative analysis (Wilcoxon W test and χ² test) and correlation analysis (φ correlation analysis).

Levels of ALT, aspartate aminortransferase (AST), globulin (GLO) and hepatitis B virus e antigen (HBeAg) positive rate were significantly different between the patients in mild inflammation group and moderate inflammation group (Z = 2.095, P = 0.036; Z = 3.927, P < 0.001; Z = 2.900, P = 0.004; χ² = 10.972, P = 0.001). The levels of AST, GLO, WBC, platelet (PLT) and HBeAg positive rate were significantly different between the patients in no significant fibrosis group and obvious fibrosis group (Z = 2.933, P = 0.003; Z = 3.064, P = 0.002; Z = 2.544, P = 0.011; Z = 2.231, P = 0.026; χ² = 10.116, P = 0.001). HBV DNA levels were not significantly different among groups of different liver tissue inflammatory activity and fibrosis degree (Z = 1.908, P = 0.056; Z = 1.729, P = 0.084). The levels of ALT and AST were associated with low degree of inflammatory activity in liver tissue (r_φ = 0.211, P = 0.044; r_φ = 0.284, P = 0.007). The levels of AST and WBC were associated with low degrees of liver fibrosis (r_φ = 0.222, P = 0.035; r_φ = 0.289, P = 0.006). The level of GLO was moderately correlated with liver fibrosis (r_φ = 0.457, P < 0.001).

For patients of CHB with ALT < 2× ULN and HBV DNA positive, HBeAg positive patients were more likely to occur liver fibrosis than HBeAg negative cases. The levels of blood WBC, PLT, AST and GLO were correlated with the degree of liver fibrosis, among which, patients with GLO > 30 g/L had higher correlation with liver fibrosis.

To investigate the efficacy of vancomycin compound antibiotic bone cement implantation on treatment of postoperative orthopedic infection.

Total of 22 patients with postoperative infection in Orthopedics Department of Luohu District People’s Hospital in Shenzhen City from January 2016 to December 2017 were seleced. All of them were treated with the vancomycin compound antibiotic bone cement implantation, and the efficacy was evaluated.

The pathogenic bacteria were cultured from the inflammatory tissue and granulation of 20 patients, among which 40% (8/20) were methicillin-resistant Staphylococcus aureus (MRSA), 30% (6/20) were Staphylococcus epidermidis, 15% (3/20) were Klebsiella pneumoniae, 10% (2/20) were Pseudomonas aeruginosa and 5% (1/20) was Staphylococcus capillaries. The interval between the first operation of 22 patients and the implantation of vancomycin compound antimicrobial bone cement beads was 16-750 d, while the retention time of the beads in vivo was 44-422 d. All patients were followed up for 4-15 months after vancomycin compound antibiotic bone cement implantation, among whom, 21 cases (95.45%) were with infection controlled, 21 cases (95.45%) were cured, 1 case (4.55%) was not with infection controlled, and the infection control rate and cure rate were both 95.45% (21/22).

Vancomycin compound antibiotic bone cement implantation is effective in treatment of orthopaedic infection, it could be used as the first choice for the treatment of orthopedic postoperative infection.

To improve the attention to the comprehensive and systematic physical examination and the understanding of the suspected patients complicated with relatively rare bacteremia.

The diagnosis and treatment of one case of with non-hodgkin lymphoma who was first diagnosed as non-typhoidal Salmonella were analyzed and relevant literatures were reviewed.

Through tracing the cause continually and auxiliary examination, the hidden illness was discovered of a 66-year-old male patient, who was diagnosed as non-hodgkin lymphoma, while first diagnosed as bacteremia of non-typhoidal Salmonella. After comprehensive anti-infection and symptomatic treatment, the patient’s temperature returned to normal. The etiology turned negative. After his condition improved, the patient was advised to superior hospital to further treatment.

Timely detection, diagnosis and standard treatment were the keys to control the infection of non-typhoid Salmonella and improve the prognosis.

To investigate the method of preventing misdiagnosis of paragonimiasis and the diagnostic value of platelets (PLT) and eosinophils (EOS) in paragonimiasis.

A case of paragonimiasis with cough for 4 months and subcutaneous mass for 2 months as the main clinical manifestation was reported. By detecting changes of PLT and EOS to explore the diagnostic value of platelets and eosinophils in paragonimiasis.

Due to the clinical symptoms, signs and chest CT results as the basis for diagnosis, no personal history and no dialectical analysis in levels of PLT and EOS changes of this case, which resulted multiple misdiagnosis. Mass excision was performed under general anesthesia after misdiagnosis. EOS and PLT gradually returned to normal levels after treatment.

Dialectical analysis of PLT and EOS was the key process to clinical diagnosis of Paragonimiasis, and antigen and antibody screen is critical to confirm the diagnosis. EOS and PLT were important indicators for the curative effect.

To improve the understanding of acquired immunodeficiency syndrome (AIDS) and central nervous system (CNS) combined infection of Cryptococcus neoformans and Mycobacterium tuberculosis.

The diagnosis and treatment of a case of AIDS combined with new cryptococcal meningitis and tuberculous meningitis were analyzed, and relevant literatures were reviewed.

On March 17th, 2015, a 38-year-old male patient with AIDS complicated with cryptococcal meningitis was admitted to Zhongnan Hospital of Wuhan University. After complete examination, the case was diagnosed as mixed infection of Cryptococcus neoformans and Mycobacterium tuberculosis. After antiinfection and comprehensive symptomatic treatment, the condition of the case was relieved and the prognosis was relatively well.

For patients with AIDS combined with cryptococcal meningitis and tuberculous meningitis, timely diagnosis, combined treatment with anti-cryptococcus and anti-tuberculosis and initiation of antiretroviral therapy at the right moment are expected to improve the prognosis.

To investigate the fundus manifestation of patients with acute retinal necrosis (ARN) examined by optical coherence tomography (OCT).

OCT, best corrected visual acuity, slit lamp anterior segment examination, indirect ophthalmoscope after mydriasis, color fundus photography, visual field, corneal endothelial examination and fundus fluorescein angiography were performed for 9 patients with ARN. The fundus changes of OCT were analyzed.

Total of 11 eyes fundus examination of 9 patients showed vitreous opacity, focal lamellar retinal necrosis of the fusion area, retinal vessel occlusion is white linear. The clinical diagnosis of ARN patients was based on typical fundus findings: yellow-white retinal necrosis, occlusive retinopathy, anterior chamber and vitreous inflammatory cells, etc. Patients with ARN were treated with acyclovir intravenously and vitrification in the event of retinal detachment.

The specific lesions observed on the OCT color fundus were consistent with the OCT images. Early and timely diagnosis and timely treatment of ARN patients by OCT could significantly improve their visual function and life quality.

To improve the awareness of cytomegalovirus retinitis after chemotherapy of Burkitt’s lymphoma.

The diagnosis and treatment of one 58-year-old patient of cytomegalovirus retinitis after chemotherapy of Burkitt’s lymphoma was analyzed and relevant literatures were reviewed.

The condition of this patient with Burkitt’s lymphoma was relieved after multicourse chemotherapy, but immune system reconstruction failed due to long-term malnutrition and low resistibility, which led to cytomegalovirus infection and cytomegalovirus retinitis. After antiviral treatment with ganciclovir injection, cytomegalovirus DNA was negative and the vision gradually improved.

Timely diagnosis and standard treatment are the keys to control cytomegalovirus retinitis after immunochemotherapy of Burkitt’s lymphoma.

To investigate the clinical characteristics, laboratory examination and treatment of Babella infection.

Data of diagnosis and treatment of a patient infected with Babella and induced hemophagocytic syndrome in Beijing Friendship Hospital, Capital Medical University on August 28th, 2017 were analyzed, retrospectively.

The patient lived in Beijing and had no contact history of epidemic water, but had a history of labor in rural areas of Hebei Province, following by fever, thirst, polyuria, edema accompanied by decreased white blood cells, red blood cells, platelet count, blood sodium, jaundice and blood chlorine. Blood smear and bone marrow smear showed that erythrocyte endosomes and suspected Babesia infection. After timely administration of antibiotics and clindamycin, all the symptoms disappeared and laboratory indexes of the patient restored.

Although the disease is reported in Northern Mongolian border, Yunnan and Southeastern coast of China, but there are still some sporadic cases in Beijing-Tianjin-Hebei region, so we still should be vigilant about the disease, which is easy to be misdiagnosed as hematological diseases and timely blood smear is very important.

To investigate the clinical characteristics and drug resistance of children infected with Streptococcus pneumoniae.

The clinical data of 224 cases with Streptococcus pneumoniae infection were selected by random sampling from January 2015 to April 2018 in the Outpatient Department of Children’s Hospital Affiliated to Nanjing Medical University. The age distribution of children with Streptococcus pneumoniae infection, the seasonal distribution, serum types and the drug resistance to antibiotics of Streptococcus pneumoniae were analyzed, respectively.

The incidence of Streptococcus pneumoniae infection among children aged 1 month to 1 year old was 56.25% (126/224), which was significantly higher than that of cases aged 1-3 years old (23.21%, 52/224) and 3-7 years old (20.54%, 46/224), both with significant differences (χ² = 51.045, 60.398; both P < 0.001). The rate of cases with Streptococcus pneumoniae infection in winter (52.67%, 118/224) was significantly higher than that in spring (20.09%, 45/224), summer (12.95 %, 29/224) and autumn (14.28%, 32/224), with significant differences (χ² = 51.392, 80.200, 74.126; all P < 0.001). There was no significant difference in the annual incidence of Streptococcus pneumoniae infection from 2014 to 2017 (χ² = 5.191, P = 0.158). The 224 Streptococcus pneumoniae strains involved 11 serotypes/groups, mainly distributed in 19F, 19A, 14, 9V, 23F, 6B, 8, 7F, 7A and others, while 11 strains could not be classified. Different serotypes were resistant to penicillin, and the insensitivity rate of penicillin (meningitis) was 75.00%. Different serotypes had different resistance to penicillin, and the insensitivity rate of penicillin (meningitis) was 75.00% (52/68), which was significantly higher than that of penicillin (non-meningitis)[56.41% (88/156)], with significant difference (χ² = 69.142, P < 0.001). The resistance rates of Streptococcus pneumoniae to erythromycin, compound norepinephrine and clindamycin were 84.82% (190/224), 78.13% (175/224) and 75.89% (170/224), respectively. But the sensitivity rates to vancomycin and chloramphenicol were 100.00% (224/224) and 96.44% (216/224), respectively.

The clinical characteristics of age, season, serum distribution and drug resistance in children with Streptococcus pneumoniae infection were helpful to guide the clinical and rational application of the antibacterial drugs.

To investigate the incidence of human papillomavirus (HPV) infection and the distribution of HPV subtypes in women for physical examination in Anhui area, and to provide evidence for the prevention and treatment of cervical cancer.

The sample of female cervical exfoliated cells specimen were collected by Hefei KingMed Diagnostics laboratory and HPV genotypes were detected by polymerase chain reaction reverse dot blot hybridization (PCR-RDB) method. According to the genotype results, the potential infection rate and HPV subtypes, the detection rate of each genotype and the distribution of different age groups were analyzed, respectively.

Among the 17 160 samples from healthy women for physical examination, a total of 2 990 cases were HPV positive, with the positive rate 17.42% (2 990/ 17 160). Seventeen high-risk genotypes and 6 low-risk genotypes of HPV were all detected. Cases with single genotype HPV infection accounted for 73.71% (2 204/2 990), double HPV genotypes infection were 19.03% (569/2 990), triple HPV genotypes were 5.55% (166/2 990); while quadruple HPV genotypes (43 cases), five genotypes (7 cases) and six genotypes (1 case) infection accounted for 1.71% (51/2 990) in total. Among the 2 204 cases with single genotype HPV infection, 1 829 (82.99%) cases were with high-risk genotypes HPV infection. The common high-risk subtypes were HPV52 (20.07%, 367/1 829), HPV16 (16.84%, 308/ 1 829), HPV53 (9.84%, 180/18 29) and HPV18 (8.26%, 151/1 829). The detection rate of the above four high-risk genotypes of HPV accounted for 55.00%, relative to the total high-risk genotype of HPV infection (1 006/1 829). The remaining 823 patients were distributed in the other 13 high-risk genotypes of HPV. There were 375 cases with low-risk genotype of HPV infection, the most common of which was HPV81 (40.00%, 150/375), followed by HPV42 (22.13%, 83/375) and HPV43 (17.33%, 65/375). The other 23 patients were distributed in the other 3 middle and low risk genotypes. Among the cases with double HPV infection, 390 cases (68.54%) were with only high-risk HPV subtypes infection, 10 cases (1.76%) with only low-risk HPV subtypes infection and 169 cases (29.70%) with high-risk and low-risk HPV subtypes mixed infection. Among the triple HPV genotypes infection, 73 cases (43.98%) were with only high-risk HPV subtypes infection, 2 cases (1.20%) were with only low-risk HPV subtypes infection and 91 cases (54.82%) with high-risk and low-risk HPV subtypes mixed infection. Among quadruple and above HPV genotypes infection, 22 cases (43.14%) were with only high-risk subtypes HPV infection, no case was with only low-risk HPV subtype infection and 29 cases (56.86%) with high-risk and low-risk HPV subtypes mixed infection. High-risk HPV subtype infection was the main infection, whether in single HPV subtype infection or in multiple HPV subtypes infection. The positive rates of HPV in groups aged 21-25, 26-30, 31-35, 36-40, 41-45, 46-50 ,51-55, 56-60 and ≥ 61 years old were significantly different (χ² = 28.701, P < 0.001).

HPV infection in healthy women in Anhui was maily single subtype infection and high-risk subtypes infection, and the high-risk infection rate ranks HPV52, HPV16, HPV53 and HPV18, and the infection rate of different age groups were significantly different.

To investigate the epidemiological, clinical and laboratory characteristics of children with brucellosis, and to provide evidence for its diagnosis in non-pastoral areas.

Clinical data of 45 children with brucellosis in non-pastoral areas from Shaanxi Provincial Center for Diseases Control and Prevention, and Xi’an Children’s Hospital from January 2014 to December 2018 were analyzed, retrospectively, and the clinical characteristics and laboratory examinations were summarized and analyzed, respectively.

The incidence of childhood brucellosis in non-pastoral areas peaked from March to September, and the incidence of childhood brucellosis increased year by year from 2014 to 2018. Among the 45 children, 19 were males and 26 were females. Children aged 0-3 years were the main group with brucellosis in non-pastoral areas (53.3%, 24/45). The main route of transmission was digestive tract transmission (64.4%, 29/45). Children with brucellosis had various clinical manifestations, the main clinical manifestations were fever (82.2%, 37/45), followed by joint swelling and pain (40.0%, 18/45) and hepatomegaly (28.9%, 13/45), while hyperhidrosis (11.1%, 5/45) and fatigue (6.7%, 3/45) were rare. Inflammation indexes were the main abnormal factos in laboratory examination, procalcitonin increased in 30 cases (66.7%), the erythrocyte sedimentation rate (ESR) increased in 10 cases (22.2%), C-reactive protein (CRP) increased in 7 cases (15.6%); no child occurred decreased total number of whole blood cells in routine examination. Among the 45 children, 35 (77.8%) cases were Brucella positive in blood culture and 10 (22.2%) cases were positive in test tube agglutination detection. Symptoms of nervous system involvement were found among 4 cases (8.9%), and Brucella was cultured in cerebrospinal fluid of the above 4 cases.

The clinical manifestations of children with brucellosis are complex . In non-pastoral areas, when children had long-term fever, joint swelling and pain, and liver enlargement, pediatricians should be highly suspicious of brucellosis and make early diagnosis and timely treatment.

To investigate the clinical characteristics of 8 patients with sporadic Creutzfeldt-Jakob disease (sCJD), and to improve the understanding of the disease.

The clinical data and results of auxiliary examinations of 8 cases with sCJD were analyzed, retrospectively, among whom 7 cases were from the Department of Neurology and 1 case from the Infection Center of Beijing Ditan Hospital, Capital Medical University from March 2012 to May 2019.

All the 8 patients had subacute onset. The main clinical characteristics included rapid progressive dementia, extrapyramidal and cerebellar symptoms, pyramidal tract signs, and psychiatric symptoms. Diffusion-weighted imaging (DWI) of magnetic resonance (MR) demonstrates symmetrical or asymmetrical lace-like high signal traveling along the cortex. The electroencephalogram (EEG) was dominated by periodic three-phase waves. Six cases among the 8 patients underwent cerebrospinal fluid 14-3-3 protein examination, all of them were positive. All patients died within 2 years after onset.

Most sCJD were subacute onset, characterized by rapid progressive dementia. The cortical lace sign of magnetic resonance DWI and periodic three-phase wave of electroencephalogram were helpful for clinicians to identify and diagnose the disease in early stage.

To improve the awareness of Listeria monocytogenes meningoencephalitis in clinical practice.

The diagnosis and treatment of a case with nephrotic syndrome complicated with Listeria monocytogenes meningoencephalitis collected from PLA Rocket Force Characteristic Medical Center at October 24th, 2018 were analyzed and relevant literature was reviewed.

The 25-year-old male patient with nephrotic syndrome complicated with Listeria monocytogenes meningoencephalitis was treated with comprehensive anti-infection therapy and symptomatic treatment. The temperature of the patient returned to normal, after the improvement of the Listeria state and meningoencephalitis, the patient was discharged from hospital, with good prognosis.

Early diagnosis and standard antibiotic treatment are the key to the state and prognosis of Listeria monocytogenes meningoencephalitis.

To summarize the clinical characteristics of 6 patients with sporadic Creutzfeldt-Jakob disease (CJD).

The clinical characteristics of 6 patients with sporadic CJD diagnosed and treated in Beijing Ditan Hosipital, Capital Medical University from January 2011 to October 2017 were analyzed, retrospectively, while the related literatures were reviewed.

Among the 6 patients with CJD, there were 3 males and 3 females, aging 54-78 years old. The first symptoms of the patients were various, mainly with rapid progressive dementia. Five patients had cognitive impairment. One patient had no clinical symptoms, but during physical examination, high signal intensity of brain lobes was found on DWI, and walking instability occurred 7 months after physical examination. High signal intensity in lobes and/or basal ganglia could be seen on DWI images among all the 6 patients. Cerebrospinal fluid 14-3-3 protein were positive in 6 patients. Electroencephalography (EEG) of 4 patients showed periodic sharp wave complexes. All the 6 patients died of pulmonary infection and respiratory failure.

The possibility of CJD should be considered even if the clinical symptoms are atypical, and the brain magnetic resonance imaging, electroencephalogram (EEG) and cerebrospinal fluid (cerebrospinal fluid) should be reviewed regularly to avoid missed diagnosis.