Objective: To identify risk factors associated with carbapenem-resistant Klebsiella pneumoniae (CRKP) infection/colonization and death and to investigate the resistance and homology of CRKP. Methods: A retrospective 1:1 case-control study was conducted at Changhai Hospital, China, from January 2010 to December 2011.The study population included 30 patients with CRKP infection/colonization and 30 matched patients with carbapenem-susceptible K. pneumoniae (CSKP) infection/colonization at the same site. Homology analysis was conducted by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Potential resistance genes were detected by PCR. .026) were independent risk factors for the death of patients with K. pneumoniae infection/colonization. Older age (OR: 1.16, 95% CI: 1.01-1.39, P50.011) was an independent risk factor for the death of patients with CRKP infection/colonization. Thirty CRKP strains were all KPC-2-producing resistant strains with genotype of ST-11. Conclusion: Exposure to glycopeptides, cefoperazone plus sulbactam and tracheostomy were independent risk factors for CRKP infection/colonization, and older age was an independent risk factor for CRKP infection/ colonization caused death.

Owing to limited data, we conducted a meta-analysis to re-evaluate the relationship between obesity and coronavirus-2019 (COVID-19). Literature published between 1 January 2020 and 22 August 2020 was comprehensively analysed, and RevMan3.5 was used for data analysis. A total of 50 studies, including data on 18 260 378 patients, were available. Obesity was associated with a higher risk of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) infection (odds ratio (OR): 1.39, 95% confidence interval (CI) 1.25–1.54; P < 0.00001) and increased severity of COVID-19 (hospitalisation rate: OR: 2.45, 95% CI 1.78–3.39; P < 0.00001; severe cases: OR: 3.74, 95% CI 1.18–11.87; P: 0.02; need for intensive care unit admission: OR: 1.30, 95% CI 1.21–1.40; P < 0.00001; need for invasive mechanical ventilation: OR: 1.59, 95% CI 1.35–1.88; P < 0.00001 and mortality: OR: 1.65, 95% CI 1.21–2.25; P: 0.001). However, we found a non-linear association between BMI and the severity of COVID-19. In conclusion, we found that obesity could increase the risk of SARS-CoV2 infection and aggregate the severity of COVID-19. Further studies are needed to explore the possible mechanisms behind this association.

I ntravenous leiomyoma (IVL) is a rare, histologically benign smooth-muscle-cell tumor that occurs only in women. This neoplasm occupies vascular spaces from the intrauterine venules to the systemic veins, including the iliac vein and inferior vena cava (IVC), and it does not invade the tissue. The mass can extend into the right heart chambers and pulmonary arteries. 1,2 Its extrauterine involvement occurs in approximately 30% of cases, and intracardiac extension accounts for about 10%. [3][4][5] This extension of IVL into the right side of the heart is called intracardiac leiomyomatosis (ICL).The diagnosis of ICL can be overlooked. Echocardiography, abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) are available for detection and diagnosis. Echocardiography is important in the initial diagnosis of ICL. To our knowledge, the literature about ICL chiefly comprises case reports, and the authors of the few case series have not in general discussed the echocardiographic characteristics and extending pathways of ICL. We retrospectively studied the cases of 7 patients with ICL who underwent successful tumor resection in our hospital. We outlined the echocardiographic characteristics of the tumors and analyzed their clinical features, confirmed the extending pathways by means of CT reports, and studied the surgical and pathologic results. We discuss the echocardiographic diagnosis of ICL and briefly review the pertinent medical literature. Patients and MethodsWe reviewed our hospital's clinical database and identified 7 women who had undergone surgical resection of ICL tumors from January 2003 through July 2012. The echocardiographic images included parasternal, apical, and subcostal views. In addition, M-mode, pulsed and continuous-wave Doppler, and color-flow Doppler images

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Patients receiving Chinese guideline-adherent regimens had better outcomes, and atypical pathogen active regimens were associated with a lower treatment failure rate and shorter length of hospital stay.

Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) is a heterogeneous disease in which the role of immunoglobulin heavy chain genes (IGH) remains unknown. To determine the clinical relevance of the IGH repertoire in LPL/WM patients, we performed immunoglobulin gene rearrangement and complementarity determining region 3 (CDR3) analysis. The IGH variable gene repertoire was remarkably biased in LPL/WM. IGHV3-23, IGHV4-34, IGHV3-30, IGHV3-7, and IGHV3-74 accounted for half of the cohorts' repertoire. Most cases (97.1%) were found to carry mutated IGHV genes, based on a 98% IGHV germline homology cutoff. IGHV3-30 was associated with long heavy chain CDR3, indicating there was specific antigen selection in LPL/WM. Patients with IGHV3-7 were significantly more likely to harbor the 6q deletion (P&lt;0.001) and an abnormal karyotype (P=0.004). The IGHV hypermutation rate in patients with the MYD88 L265P mutation was significantly higher than that of wild-type patients (P=0.050). IGHV3-23 and IGHV3-74 segments were more frequently detected in mutated MYD88 LPL/WM patients (P=0.050), while IGHV3-7 presented more frequently in MYD88 wild-type patients (P=0.042). Patients with IGHV4, especially IGHV4-34, had higher levels of lactate dehydrogenase, and IGHV4 was a predictive marker of shorter progression-free survival. These results showed for the first time that the IGHV repertoire has clinical relevance in LPL/WM.

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