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Objective:To compare the effect of fluorescence staining and periodic acid-Schiff staining in the diagnosis of fungal keratitis (FK).Methods:A total of 147 corneal specimens from 147 FK patients treated in Eye Hospital of Shandong First Medical University from January 2017 to May 2019 with positive corneal scraping or fungal culture were collected.Among them, there were 84 cases with penetrating keratoplasty (PKP), 42 cases with lamellar keratoplasty (LKP) and 21 cases with lesion resection.Another 11 cases with herpes simplex virus keratitis served as negative control.The corneal tissue specimens were performed with fungal fluorescence staining and periodic acid-Schiff staining, respectively.The stained sections were placed under fluorescence microscope and optical microscope to observe fungal hyphae or spores, respectively.The positive rates of the two staining methods were compared, and the positive cases of the diagnosis of FK in corneal tissue samples obtained by different surgical methods and corneal infection caused by different strains of the two staining methods were compared.Written informed consent was obtained from each patient.The study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Shandong Eye Hospital (No.SDSYKYY-2016012).Results:The positive rate of periodic acid-Schiff staining and fungal fluorescence staining was 60.5% (89/147) and 79.6% (117/147), respectively.The positive rate of fluorescence staining in the diagnosis of fungal keratitis was significantly higher than that of periodic acid-Schiff staining ( χ2=28.00, P<0.01), and both the specificity of the two staining methods was 100%.The positive rate of specimens obtained by PKP with fluorescent staining was 85.7% (72/84), and the positive rate with periodic acid-Schiff staining was 65.5% (55/84), and the difference was statistically significant ( χ2=17.00, P<0.01). The positive rate of specimens obtained by LKP with fluorescent staining was 71.4% (30/42), and the positive rate with periodic acid-Schiff staining was 52.4% (22/42), and the difference was statistically significant ( χ2=8.00, P<0.01). The positive rate of resected foci specimens with fluorescent staining was 71.4% (15/21), and the positive rate with periodic acid-Schiff staining was 57.1% (12/21), and the difference was not statistically significant ( χ2=1.30, P=0.25). The positive cases of two kinds of staining were different among different fungal strains.Among them, the positive cases of Fusarium solani complex, Pythium insidiosum, Aspergillus fumigatus complex, Candida guilliermondii, Trichoderma and Nigrograna mackinnonii with fluorescence staining were 19, 5, 5, 1, 1 and 1, and the positive cases of periodic acid-Schiff staining were 11, 0, 3, 0, 0 and 0, respectively.The staining results of the 11 negative controls were negative. Conclusions:Fluorescence staining is more sensitive than periodic acid-Schiff staining in the detection of fungal components in paraffin-embedded corneal tissues, and it can significantly improve the fungal detection rates.
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Objective@#To investigate and analyze clinical symptoms, auxiliary examination results, therapeutic methods and the prognosis of the pneumonia caused by Mycoplasma pneumoniae in children.@*Methods@#The clinical data including symptoms, auxiliary examination results, therapeutic methods of 125 children with Mycoplasma pneumoniae pneumonia in our hospital from September 2016 to February 2017 were retrospectively analyzed.@*Results@#Among the 125 children with Mycoplasma pneumoniae pneumonia, the main symptoms were cough (100%) and fever (68%) and some cases accompanied by different extra-pulmonary complications. Varying degrees of changes were found from all the children’s abnormal chest X-ray films.@*Conclusions@#The symptoms of Mycoplasma pneumoniae pneumonia in children were serious, with slight clinical signs and varying degrees of change of the X-ray films. Early standardized application of macrolide antibiotics was beneficial for treatment.
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Objective To explore the application of self-made guided wire operating-tray,which is designed for percutaneous tranluminal coronary angioplasty (PTCA),in performing coronary intervention (PCI).Methods A total of 40 patients who were planned to receive PCI were randomly divided into the study group (n=20,using guided wire operating-tray) and the control group (n=20,using traditional method to operate guide wire).Under local anesthesia PCI was carried out in all patients of both groups.The frequency of guide wire winding,the degree of surgical sheet contamination within the operation area,and the comfort and convenience of operating guide wire were assessed,the results were compared between the two groups.Results The frequency of guide wire winding and the degree of surgical sheet contamination within operation area in the study group were remarkably lower than those in the control group (P＜0.05).The comfort and convenience of operating guide wire in the study group was better than that in the control group (P＜0.05).Conclusion In performing PCI,the use of self-made guided wire operating-tray can effectively avoid guide wire winding and reduce the degree of surgical sheet contamination within the operation area.
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Objective to determine predictive factors of intestinal obstruction in acute myocardial infraction (AMI) patients after primary percutaneous coronary intervention (PCI) and to establish predictive model.Methods A total of 1220 AMI patients underwent primary PCI in Jiangxi provincial people's hospitalfrom June2004 toJune 2014were retrospectively analyzed.And 1025 cases of them whichall met the inclusion and exclusion criteriawere randomlydivided by using random number generated by SPSS 17.0 into two cohorts:model derivation cohort (MDC) and model validation cohort (MVC).MDC was divided into intestinal obstruction group and control group.predictive factors were identified using univariable andmultivariable logistic regression analysis in MDC.Interger point values were assigned to each predictor based upon their coefficient in multivariable logistic regression model to establish scoring model.The summed scores of each case in MVC were calculated to test predictive ability of the model by ROC cure.Results Total of 1 025 patients,103 patients were diagnosed with different types of intestinal obstruction and the incidence of intestinal obstruction was 10.0％.Low position intestinal obstruction,incomplete intestinal obstruction and simple intestinal obstructionwere main characteristics in these patients.logistic regression analysis identified ten risk factorscan predict the appearance of intestinal obstruction:age ＞ 65years old (OR =1.44,95％ CI:1.26-4.63,P =0.000),diabetes mellitus (OR =3.37,95％ CI:2.39-9.47,P =0.000),habitual constipation (OR =4.75,95 ％ CI:3.58-11.24,P =0.024),inferior and extensive anterior wall myocardial infarction (OR =2.16,95％ CI:1.94-4.79,P =0.017),cardiac functiongrade≥3 class (Killip classification) (OR=2.86,95％CI:1.98-5.67,P=0.002),femoral approach (OR=2.76,95％CI:1.38-6.12,P=0.002),K+ ＜3.5 mmol/L (OR=1.86,95％CI:1.11-5.47,P =0.005),taking laxative (OR =3.59,95％ CI:2.99-10.21,P =0.000),using morphine (OR =1.98,95％ CI:1.07-3.12,P =0.021) and estimated glomerular filtration rate (eGFR) ＜60 mL · min-1 · 1.73m-2 (OR =1.19,95％ CI:1.10-3.22,P =0.031).and areas under the ROC cure was 0.815 (95％ CI:0.802-0.883,P =0.000) and indicating the accuracy of predicting intestinal obstruction.Conclusions age ＞ 65 years old,diabetes mellitus,habitual constipation,inferior and extensive anterior parts of myocardial infarction,cardiac functiongrade ≥3class (Killip classification),femoral approach,K + ＜3.5mmol/L,taking laxative,using morphine and eGFR ＜ 60 ml.min-1.1.73m2 were important predictive factors for intestinal obstruction in AMI patients after underwent 0 and the scoring model can predict accurately intestinal obstruction in such patients.
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[ABSTRACT]AIM:Tostudytherelationshipbetweenhuman8-oxoguanineglycosylase1(hOGG1)gene Ser326Cys polymorphism and severity of coronary artery lesions in the patients with diabetes mellitus .METHODS: We retrospectively analyzed 323 patients with diabetic mellitus receiving coronary angiography .These patients underwent the test of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and were divided into Cys/Cys genotype (n=85), Ser/Ser genotype (n=121) and Ser/Cys genotype (n=117) according to the results of PCR-RFLP. All clinical data including history of diseases , complications and biochemical markers , such as blood glucose , blood lipids and so on, were recorded.hOGG1 mRNA and 8-hydroxydeoxyguanosine (8-OHdG) were measured by RT-PCR and ELISA, respectively.The results of coronary angiography such as number and severity of coronary artery with lesions were analyzed by 2 cardiovascular physicians .Gensini score and SYNTAX score were also detected by the unitary criteria .RE-SULTS:(1)8-OHdG in Cys/Cys genotype was higher than that in Ser /Ser genotype and Ser/Cys genotype (P0.05).(2)hOGG1 mRNA ex-pression in Cys/Cys genotype was lower than that in Ser/Ser genotype and Ser/Cys genotype (P0.05) was observed.(3)The probability of triple vessel lesions in Cys/Cys genotype was high and the probability of single vessel lesions in Ser /Cys genotype was low , but the difference among 3 genotypes was not statistically significant (P>0.05).(4)Gensini score and SYNTAX score in Cys/Cys genotype were 48.7 ±15.3 and 39.5 ±17.2, respectively, and the ratio of complex lesions in Cys/Cys genotype was 73.0%.These scores and the ratio of complex lesions were higher than the other 2 genotypes (P0.05).CONCLUSION:hOGG1 gene Ser326Cys polymorphism has relationship with coronary artery lesions in the patients with diabetes mellitus and Cys /Cys genotype might have some impacts on the severity of lesions .The mRNA expression of hOGG1 in the patients with diabetes mellitus carrying Cys/Cys genotype is lower than that in the patients carrying the other 2 genotypes , then decreases the abil-ity of identification and removal of 8-OHdG and the capacity of repairing DNA oxidative damage , and accelerates the devel-opment of atherosclerosis .
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Objective To evaluate the influence of empowerment education on self-management ability and self-efficacy of patients with coronary heart disease (CHD).Methods 190 patients with CHD were randomly divided into the experimental group and the control group.And all patients were trained respectively according to corresponding health education plan of each group by professional worker.These patients filled out the Essential Information Questionnaire (EIQ),Self-Efficacy Integration Scale (SEIS) and Coronary Artery Disease Self-management Scale(CSMS) at baseline,3 months and 6 months after health education.The clinical indexes in two groups such as body mass index,waistline,blood pressure,blood glucose and blood lipid were contrasted.Results The score of self-management ability and the score of self-efficacy in the experimental group was significantly more than that of the control group in 3 months and 6 months after health education,and this difference between two groups still persisted 6 months after health education.However,the score of symptom-maintaining in the SEIS and self-management of addiction,emergency,lifestyle and knowledge of diseases in the CSMS appeared to drop in the control group.Conclusions Empowerment education can significantly improve and increase the self-management ability and self-efficacy of patients with CHD,and this function of empowerment education was proved more enduring than that of traditional health education.So,empowerment education will be a new style of health education in the new model of clinical medicine instead of traditional health education.