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Objective@#To explore the value of chest CT features and clinical indexes in the differential diagnosis between suspected COVID-19 with two or more negative nucleic acid tests and confirmed COVID-19.@*Methods@#The clinical data and chest CT images of 105 cases withconfirmedCOVID-19 (55 males and 50 females, aged from 2 month to 88 years) and 97 cases with suspected COVID-19(59 males and 38 females, aged from 1 month to 93 years) were analyzed retrospectively in Shiyan Taihe Hospital from January 21 to February 10, 2020. χ2test and two independent sample t test were used to analyze the clinical data and CT signs of the two cases, with P<0.05 for the difference statistically significant.@*Results@#Compared with the suspected patients, the average age of diagnosis of covid-19 was higher (t = 2.460, P = 0.01). The main pathological changes were pure ground glass (68 cases) and mixed ground glass density (53 cases) (χ2 = 50.016, P< 0.01). Interstitial thickening (83 cases) (χ2 = 55.395, P< 0.01), vascular thickening (73 cases) (χ2 = 57.527, P< 0.01), air bronchoscopic sign or bronchiectasis Zhang (67 cases) (χ2 = 17.899, P< 0.01), cord focus (54 cases) (χ2 = 5.500, P = 0.02), easily distributed under the pleura and the long axis of the lesion was parallel to the pleura (89 cases) (χ2 = 23.597, P< 0.01), most of them had no pleural effusion (χ2 = 7.017, P< 0.01); both lesions were mainly distributed in patches (89 cases were confirmed, 87 suspected) (χ2 = 19.573, P< 0.01). In addition, the lesions of patients with confirmed covid-19 showed progress in short term (72 / 87, 82.76%), and those with suspected covid-19 showed remission in short term (63 / 89, 70.78%). The difference was statistically significant (χ2 = 51.114, P< 0.01). There was no significant difference in gender and distribution of pulmonary lobes (χ2 = 1.462, P= 0.23; χ2 = 7.381, P= 0.19). The number of white blood cells (χ2 = 17.891, P< 0.01) and the percentage of lymphocytes (χ2 = 11.151,P< 0.01) of covid-19 were mostly normal or decreased, creatine kinase (χ2 = 9.589, P< 0.01) were mostly normal, and erythrocyte sedimentation rate was mostly normal or increased (χ2 = 4.240, P= 0.04).@*Conclusions@#The imaging features and biochemical indexes of diagnosed COVID-19 are different from those of suspected COVID-19. The comparative analysis of imaging features, clinical indexes and reexamination are helpful for the differential diagnosis of COVID-19 and suspected COVID-19.
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Objective:To explore the value of chest CT features and clinical indexes in the differential diagnosis between suspected COVID-19 with two or more negative nucleic acid tests and confirmed COVID-19.Methods:The clinical data and chest CT images of 105 cases with confirmed COVID-19 (55 males and 50 females, aged from 2 month to 88 years) and 97 cases with suspected COVID-19 (59 males and 38 females, aged from 1 month to 93 years) were analyzed retrospectively in Shiyan Taihe Hospital from January 21 to February 10, 2020. χ 2test and two independent sample t test were used to analyze the clinical data and CT signs of the two group cases, with P<0.05 for statistically significant difference. Results:Compared with the suspected patients, the average age of confirmed ones was higher ( t=2.460, P=0.01). The main pathological changes were pure ground glass (68 cases) and mixed ground glass density (53 cases) (χ 2=50.016, P<0.01). Interstitial thickening (83 cases) (χ 2=55.395, P<0.01), vascular widening (73 cases) (χ 2=57.527, P<0.01), air bronchogram sign or bronchiectasis (67 cases) (χ 2=17.899, P<0.01), fibrous streak shadow (54 cases) (χ 2=5.500, P=0.02), commonly distributed under the pleura and the long axis of the lesion was parallel to the pleura (89 cases) (χ 2=23.597, P<0.01), most of them had no pleural effusion (χ 2= 7.017, P<0.01); both lesions were mainly distributed in patches (89 confirmed cases, 87 suspected cases) (χ 2=19.573, P< 0.01). In addition, the lesions of patients with confirmed COVID-19 showed progress in short term (72/87, 82.76%), and those with suspected COVID-19 showed remission in short term (63/89, 70.78%). The difference was statistically significant (χ 2=51.114, P< 0.01). There was no significant difference in gender and distribution of pulmonary lobes (χ 2=1.462, P=0.23; χ 2= 7.381, P=0.19). The number of white blood cells (χ 2=17.891, P<0.01) and the percentage of lymphocytes (χ 2=11.151, P<0.01) of COVID-19 were mostly normal or decreased, creatine kinase (χ 2=9.589, P<0.01) was mostly normal, and erythrocyte sedimentation rate was mostly normal or increased (χ 2=4.240, P=0.04). Conclusions:The imaging features and biochemical indexes of diagnosed COVID-19 are different from those of suspected ones. The comparative analysis of imaging features, clinical indexes and follow up examination are helpful for the differential diagnosis of COVID-19.
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Objective@#To investigate the clinical features, treatment and prognosis of the patients with B-cell chronic lymphoproliferative disorders (B-CLPD).@*Methods@#The data of 40 patients with B-CLPD in the Third People's Hospital of Kunshan from September 2010 to June 2017 were retrospectively analyzed, including clinical features, laboratory inspections, immunophenotyping, genetics and molecules results, therapeutic regimens, evaluation of curative effect and disease outcome.@*Results@#There were 29 male and 11 female patients in 40 B-CLPD patients, with a median age of 71.5 years old (47-88 years old). The percentage of chronic lymphocytic leukemia (CLL) was 57.5% (23/40), monoclonal B lymphocytosis was 10.0% (4/40), Waldenstrom macroglobulinemia was 15.0% (6/40), marginal/splenic marginal zone lymphoma was 12.5% (5/40), and mantle cell lymphoma was 5.0% (2/40). The immunophenotyping of the whole patients had the expressions of CD19, and surface immunoglobulin light chain in cytomembrane of 37 patients had a restrictive expression. All CLL patients presented the expressions of CD5 and CD23, while the other types of B-CLPD expressed various level of CD20, CD22, CD10, CD5, FCM-7. Twenty-six patients received chemotherapies including purine analogue, anthracyclines, alkylating agents and hormone. The overall response rate (complete remission plus partial remission) was 69.2% (18/26). The complete remission rate was 15.4% (4/26), which only occurred in the cohort of CLL patients who received the regimen containing fludarabine. The median follow up time of 26 patients who received medical treatment was 42.8 months (0.5-82.0 months), not reaching the median survival time.@*Conclusions@#The clinical features of B-CLPD are various, which requires comprehensive analysis of clinical data, including medical history, laboratory findings, imageological examination, cell morphology, immunophenotyping, genetics as well as molecular biology. The choice of the treatment should take the individualized situation into consideration.
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Objective To study the serum level of macrophage inflammatory protein-1α(MIP-1α) and interferon gamma inducible protein-10 (IP-10) in acute myelogenous leukemia (AML) and clarify their clinical significance. Methods Enzyme-linked immunosorbent assay was used to detect the level of MIP-1α and IP-10 in serum samples from 34 AML patients(observation group) and 20 volunteers (normal control group). Results The levels of MIP-1αand IP-10 in observation group before induction chemotherapy were significantly higher than those in normal control group (P<0.05). The levels of MIP-1αand IP-10 in observation group after induction chemotherapy were decreased, and significantly lower than those before induction chemotherapy (P<0.05). After treatment for one course, 21 patients reached complete remission (CR), and 13 patients did not reach CR. The levels of MIP-1αand IP-10 in CR group had no significant difference compared with those in normal control group (P<0.05), but the levels of MIP-1αand IP-10 in none CR group were significantly higher than those in normal control group and CR group (P<0.05). The drop percentage of MIP- 1αlevels in CR group and none CR group was (32.51 ± 10.34)% and (10.57 ± 10.39)%, and there was significant difference (P<0.05). The drop percentage of IP-10 levelsin CR group and none CR group was(45.94 ± 13.68)% and (31.17 ± 11.85)%, and there was significant difference (P<0.05). Liner correlation analysis revealed that the levels of MIP-1αand IP-10 had significantly positive correlation in AML patients (r=0.652, P<0.05). Conclusions Different expressions of serum MIP-1α and IP-10 are found before and after induction chemotherapy AML patients, and there is significant correlation. Combined detection of serum MIP-1αand IP-10 may be used as an index to monitor clinical stages and prognosis.
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Objective To investigate the methylation situation of let‐7a‐3 promoter in patients with chronic myeloid leukemia (CML) and its clinical significance .Methods The methylation level of let‐7a‐3 promoter in the bone marrow mononuclear cells of 52 CML patients and 25 controls was detected by using the real‐time quantitative methylation‐specific PCR (RQ‐PCR) .Results The non-hypomethylation of let‐7a‐3 promoter was positive in 31 cases(59 .6% ) of 52 CML patients ,while only 1 case(4% ,1/25) in the control group ,the difference between the two groups were statistically significant (P0 .05) .The non-hypomethylation level of let‐7a‐3 in chronic phase and accel‐erate phase was significantly higher than that in blastic crisis of CML .Conclusion The hypomethylation level of let‐7a‐3 promoter is decreased with disease progression .