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The clinical data of a child with disseminated tuberculosis with osteomyelitis of the right little finger as the first manifestation who was admitted to Tianjin Children's Hospital on April 8, 2023 were retrospectively analyzed. The child, a 14-year-old female, presented with osteomyelitis of the right little finger as the first manifestation. She still had recurrent fever after focal incision and drainage. She was referred to our hospital. The samples from multiple sites were positive for molecular biology detection of Mycobacterium tuberculosis. She was considered as disseminated tuberculosis and was given anti-tuberculosis treatment. The child has recovered well. Pediatric disseminated tuberculosis has variable clinical manifestations and lacks specificity. It is often misdiagnosed and has a high mortality rate. Clinicians should improve their understanding of the disease and ensure early diagnosis and treatment.

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OBJECTIVE: This study aimed to investigate the clinical characteristics and long-term prognosis of mycoplasma pneumoniae pneumonia (MPP)-associated thrombosis and to gain a better understanding of the diagnosis and treatment of the disease. METHODS: The medical records of 14 children with MPP-associated thrombosis between January 2016 and April 2020 were retrospectively reviewed at the Tianjin Children's Hospital. RESULTS: The ages of the patients ranged from 3 to 12 years old. Among the 14 cases, there were five cases of pulmonary embolism, two cases of cerebral infarction, one case of splenic infarction, one case of cardiac embolism, two cases of cardiac embolism with comorbid pulmonary embolism, one case of internal carotid artery and pulmonary embolism, one case of combined internal carotid artery and the cerebral infarction, and one case combined cardiac embolism and lower limb artery embolism. All cases had elevated D-dimer levels. After thrombolysis and anticoagulation therapy, three cases with cerebral embolism still suffered from neurological sequelae. In contrast, the remaining cases did not develop complications. CONCLUSION: MPP-associated thrombosis can occur in any vessel of the body. Thrombosis-associated symptoms may be complex and non-specific. Elevated D-dimer levels in a child with refractory mycoplasma pneumoniae pneumonia should raise suspicion of thrombosis. The long-term prognosis of thrombosis was favorable after the timely administration of anticoagulant therapy.

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Objective: To analyze features and the related factors of myoclonus of 47 patients with probable or possible Creutzfeldt-Jakob disease (CJD). Methods: All patients diagnosed with"suspected CJD" and hospitalized in Xuanwu Hospital from January 2013 to November 2015 were included, and their clinical information and myoclonus features were analyzed. Age, clinical, course and manifestation, EEG, MRI, CSF14-3-3 features between myoclonus positive group and negative group were compared, and the correlation between myoclonus features and these factors was analyzed using Spearman correlation analyses. Results: (1) Occurrence rate of extrapyramidal symptoms (P=0.028), visual impairment (P=0.025) and dyssomnia (P=0.004) were higher in myoclonus positive group, the differences were significant. Spearman correlation analysis showed that myoclonus was related to extrapyramidal symptoms (P=0.024), visual impairment (P=0.030) and dyssomnia (P=0.001). (2) EEG features showed no significant difference between myoclonus positive and negative group. The 17 myoclonus positive patients were divided into three subgroups, typical EEG change group 52.94%(9/17), atypical EEG change group 23.53%(4/17) and no EEG change group 23.53%(4/17). Difference of myoclonus and other clinical manifestations were not significant among the three subgroups(P>0.05); correlation analysis also found no statistically significant correlation between myoclonus and EEG (P=0.201). Conclusions: Myoclonus often occurs after the damage of locomotor system (including pyramidal tract, extracorticospinal tract and cerebellum) among CJD patients, and it is related to extrapyramidal symptoms , visual impairment and dyssomnia . There is undefined correlation between myoclonus and periodic sharp wave complexes (PSWC) in EEG.

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Objective: To assess the imaging features of 43 patients diagnosed as clinically possible or probable Creutzfeldt-Jakob disease (CJD) for providing referential information and experience on applications of MRI in the clinical diagnosis and treatment of CJD. Method: All patients who were diagnosed with "suspected CJD" and hospitalized in Xuanwu Hospital from January 2013 to November 2015 were collected, and their clinical information and MRI imaging features were analyzed retrospectively. Results: Totally 62 patients with "suspected CJD" were rectruited in this study, and 43 of them were diagnosied as probable and possible CJD when they were discharged.The typical MRI feature of CJD patients was "cortical ribbon" sign in MR DWI sequences and/or high signal in cortex or bilateral basal ganglia.In all patients, the simple coritcal involvement was the highest(76.47%, 26/34), followed by the cortical cortex and basal ganglia(23.53%, 8/34). MRI positive group had more prominent extrapyramidal symptoms than MRI negative group (26/31 vs 9/12, P=0.015), but no statistical difference in clinic feature was found between the group with simple cortex affected and the group with both cortex and bilateral basal ganglia affected (P>0.05). Conclusions: MRI images of patients with CJD have special characteristics and have corresponding changes when the patients are in different stages of disease. In combination with the clinical evaluation of disease progression, brain microscopic pathological changes of CJD patients can be assessed by regularly brain MRI examination.

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OBJECTIVE: To study the information processing speed and the influential factors in multiple sclerosis (MS) patients. METHODS: A total of 36 patients with relapsing-remitting MS (RRMS), 21 patients with secondary progressive MS (SPMS), and 50 healthy control subjects from Xuanwu Hospital of Capital Medical University between April 2010 and April 2012 were included into this cross-sectional study.Neuropsychological tests was conducted after the disease had been stable for 8 weeks, including information processing speed, memory, executive functions, language and visual perception.Correlation between information processing speed and depression, fatigue, Expanded Disability Status Scale (EDSS) were studied. RESULTS: (1)MS patient groups demonstrated cognitive deficits compared to healthy controls.The Symbol Digit Modalities Test (SDMT) (control group 57±12; RRMS group 46±17; SPMS group 35±10, P<0.05) and Paced Auditory Serial Addition Task (PASAT) (control group 85±18; RRMS group 77±20; SPMS group 57±20, P<0.05) impaired most.SPMS patients were more affected compared to patients with RRMS subtypes, and these differences were attenuated after control for physical disability level as measured by the EDSS scores.MS patients, especially SPMS subtype, were more severely impaired than control group in the verbal learning test, verbal fluency, Stroop C test planning time, while visual-spatial function and visual memory were relatively reserved in MS patients.(2) According to the Pearson univariate correlation analysis, age, depression, EDSS scores and fatigue were related with PASAT and SDMT tests (r=-0.41--0.61, P<0.05). Depression significantly affected the speed of information processing (P<0.05). CONCLUSIONS: Impairment of information processing speed, verbal memory and executive functioning are seen in MS patients, especially in SPMS subtype, while visual-spatial function is relatively reserved.Age, white matter change scales, EDSS scores, depression are negatively associated with information processing speed.

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117 cases of acute arsenic poisoning, caused by ingestion of food contaminated by As2O2, presented with abdominal pain, vomiting, nausea and diarrhea. The average level of urinary arsenic was 3.926 mg/L. The incidence of neuritis, poisoning hepatopathy and abdominal ECG was respectively 7.7%, 32.54%, 35.9%. All the cases recovered after oral or parenteral administration of dimecapto succinate (DMS) in six weeks. DMS is the drug of choice in the treatment of arsenic poisoning.

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From Dec. 1985 to July 1988, 2006 patients with renal calculi were treated with Zhongshan Hospital JT-ESWL-I and France EDAP machines. Post-treatment obstruction of ureteral street stones occurred in 20 patients (1% in this series) with large renal calculi: 10 cases occurred in the left ureter, whereas the others in the right. The length of street stones measured 3-22 cm. Among the 20 cases, 14 patients were cured by medicine, repeated ESWL, or/and endoscopical manipulation. Two patients with acute renal failure were completely free of ureteral stones after nephrostomy or placement of a ureteral catheter and irrigation. 2 patients are still under treatment. In addition, some factors of the formation, prevention and treatment of the ureteral street stones are discussed in this paper.

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