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In the past years, only a few studies with a limited number of adult patients analyzed clinical features of allied disorders of Hirschsprung's disease (ADHD), most of which were individual case reports or lacked detailed clinical information. Although many studies have reported patients presenting to the emergency department (ED) with recurrent abdominal symptoms for a number of disorders, there are few data involving ADHD. However, owing to a lack of awareness of the disease, misdiagnoses and mistreatments are common. Severe complications such as perforation, bleeding, malabsorption, and even death in ADHD had been reported by many studies.To assist ED clinicians in having a more comprehensive understanding of this disease and making an early suspected diagnosis of ADHD more effectively.We enrolled 53 patients who visited the ED and were eventually diagnosed with ADHD over the past 11 years in our hospital. Their basic information, clinical manifestations, and imaging findings were analyzed. Blood indices were compared between the ADHD and irritable bowel syndrome (IBS) groups.Adult patients with ADHD had a mean age of 48.8 ± 14.3 years, and 77.4% had been treated before admission. The transverse colon was the most common dilated part (73.6%), and constipation (67.9%) was the most common symptom. ADHD patients can present with uncommon symptoms and false-negative imaging findings. Logistic regression analysis indicated that body mass index (BMI) [odds ratio (OR) = 0.786,Emergency physicians should be vigilant regarding patients with chronic constipation, abdominal pain, or abdominal distension, and consider the possibility of ADHD despite its rarity. Abdominal computed tomography examination is recommended as a useful tool in the suspected diagnosis of ADHD. BMI, cholinesterase, and blood chlorine have good discriminative abilities between ADHD and IBS. The nutritional status of adult patients with ADHD is worthy of further attention. Surgical treatment for adult patients with ADHD is important and inevitable.

Hepatic veno-occlusive disease (HVOD) has attracted increasing attention in recent years due to its relationship with ingestion of Gynura segetum. The mortality of severe HVOD remains high due to the lack of specific therapies. The aim of the study was to delineate the clinical characteristics and outcomes and explore the potential prognostic factors of HVOD.This was a single-center retrospective study. Eighty-nine HVOD patients were screened from the First Affiliated Hospital of Zhejiang University with an ingestion history of G. segetum before developing symptoms from January 2009 to May 2018. The enrolled patients were divided into the survivor and death groups according to the clinical follow-up that ended on September 1, 2019. The demographic variables and clinical data of the patients were recorded. A binary logistic regression analysis and receiver operating characteristic curve were conducted to identify the prognostic factors and assess the prognostic value for predicting death, and a survival analysis was performed to evaluate the clinical outcomes.Sixty-four patients were eligible for further analysis. Most patients showed abdominal distension and were positive for migrating dullness in the abdomen (P = 0.740 and P = 0.732, respectively). The patients who died had higher levels of model for end-stage liver disease score, and higher prothrombin time than those who survived (both P 0.001). All HVOD patients in both the survival and death groups showed ascites with abnormal imaging presentations of the liver parenchyma and hepatic blood vessels. Unexpectedly, we found that hydrothorax was detected in 21 (65.63%) patients in the death group and 19 (59.38%) patients in the survivor group during hospitalization, which was rarely mentioned in previous studies. Furthermore, international normalized ratio (INR) and creatinine are found to be potential independent prognostic factors for predicting death. Six severe patients achieved clinical improvements and survived after liver transplantation.HVOD can be induced by the ingestion of G. segetum, and INR combined with creatinine has prognostic value for predicting death. Liver transplantation may be an effective treatment option for severe HVOD patients.

This single-center retrospective study aims to investigate the clinical features of esophageal foreign bodies (EFBs) and determine the influence of EFB shapes on management and prognosis. A total of 427 patients aged 13 to 95 years with suspected EFB ingestion were enrolled between January 2013 and June 2018, 183 of whom were male. EFBs were divided into six shapes: pin (n = 161), sheet (n = 97), trident (n = 51), spindle (n = 66), irregular (n = 46), and sphere (n = 6). Spindle-shaped EFBs correlated with a significantly higher rate of perforation and severe complications (P P = 0.021, respectively) than any other EFB shape, while sheet-shaped EFBs were linked to less severe complications (P = 0.006). The number of pressure points was provided to stratify the risk of poor prognosis for each shape. EFBs with only two pressure points (pin and spindle EFBs) required more advanced management strategies and were correlated with a higher number of patients suffering esophageal perforation (27.11%) and severe complications (12.44%) when compared with other shapes (χ2 = 11.149 and P = 0.001; χ2 = 5.901 and P = 0.015, respectively). Spindle shape was an independent risk factor for poor prognosis, and contributed a more clinical risk than the pin shape. In conclusion, clinical features, management, perforation rate, and severe complications differed based on EFB shape. The EFBs with two pressure points, especially the spindle-shaped EFBs, were more dangerous compared with those with more pressure points.

In this study, a molecularly imprinted polymer solid phase extraction method combining high performance liquid chromatography was developed to determine the residues of tetracycline drugs in animal derived foods. The polymer was synthesized with chlortetracycline as template molecule, methacrylic acid as functional monomer at template/monomer ratio of 1:4. The prepared solid phase extraction column was able to capture four tetracyclines simultaneously with high adsorption capacities (3560–4700 ng) and high recoveries (>87%), and was able to be reused for at least thirty times. The limits of detection were in a range of 20–40 ng/g, and the recoveries from fortified blank samples (milk, egg and pork) were in a range of 74%–93%. Furthermore, the polymer-based column achieved better purification effect than three commercial solid phase extraction columns. This is the first study reporting the use of chlortetracycline based molecularly imprinted polymer for determination of tetracyclines in animal derived foods.

In this study, a method combining molecularly imprinted polymer-solid phase extraction (MIP-SPE) and high performance liquid chromatography was developed to determine the residues of fluoroquinolone drugs in milk. During the experiments, different templates, functional monomers, porogens and template/monomer ratios were evaluated. The norfloxacin based MIP capable of recognizing four fluoroquinolones (ciprofloxacin, norfloxacin, enrofloxacin and lomefloxacin) was used to prepare the SPE cartridge. The MIP-SPE cartridge showed high adsorption capacities (≥4520 ng) and high recoveries (≥96%) to the four drugs, and could be reused for at least fifty times. Then the four drugs were fortified into blank milk samples respectively to be analyzed. The limits of detection were in the range of 10–20 ng mL−1 and the recoveries were in the range of 76.8–97.7% with coefficients of variation lower than 8.3%. Furthermore, the MIP-SPE cartridge showed a better purification effect than three commercial SPE cartridges. This is the first study reporting the use of norfloxacin based MIP-SPE for determination of fluoroquinolones in milk.

This retrospective and a single-center study evaluated the prognostic value of the maximum serum creatinine value (maxCr) and the maximum serum creatinine growth rate (Vmax) after paraquat (PQ) ingestion. One hundred and seventy-one patients with PQ poisoning were treated with a uniform protocol. Demographic variables, clinical manifestations, relevant laboratory data, maxCr and Vmax of all patients were recorded and calculated. The time after PQ ingestion of maxCr and Vmax were also recorded. Vmax and MaxCr exhibited statistically significant differences between the survivor (n = 53) and death (n = 118) groups. Vmax appeared earlier in the death group than the survivor group. Regard to the receiver operating characteristic (ROC) curve analysis, Vmax had an AUC of 0.861 (95% CI, 0.801–0.921) and the optimal cut-off value of 6.21 μmol/(L·h) (sensitivity, 76.3%; specificity, 81.1%). MaxCr had an area under the curve (AUC) of 0.821 (95% CI, 0.752–0.889) and the optimal cut-off value of 225.5 µmol/L (sensitivity, 82.2%; specificity, 67.9%). The comparison of the AUC in the two parameters showed no significant difference, but Vmax appeared earlier than maxCr. Based on binary logistic regression analysis, MaxCr and Vmax both showed strong predictive powers for evaluating the prognosis of acute PQ poisoning patients.

In the Off Pump Canary Artery Bypass Graphed(CABG) surgery,a robot is usually used to dynamically track the Point of Interest(POI) on the beating heart.To achieve better tracking performance and cancel the relative motion of the heart and the assisted robotics,an adaptive Auto-regessive(AR) linear model of heart motion was built to convert the complicated heart motion tracking problem to a dynamic model following problem.The Kalman filter was used to estimate the motion state of the assisted system and the linear quadratic optimal tracking theory was used to implement the model-following method.The results show that the model-following method which provides estimated future reference enables the robot to improve the relative motion cancellation ability by 30% and decrease the tracking error by 0.25 mm.The comparison tracking result on 3D test bed Phantom robotics is reported,which proves that the model-following method enhances the ability of dynamic relative motion cancellation during the CABG sugary.