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BACKGROUND@#Type 2 diabetes mellitus (T2DM) is an independent risk factor for colorectal cancer (CRC), and the patients with CRC and T2DM have worse survival. The human gut microbiota (GM) is linked to the development of CRC and T2DM, respectively. However, the GM characteristics in patients with CRC and T2DM remain unclear.@*METHODS@#We performed fecal metagenomic and targeted metabolomics studies on 36 samples from CRC patients with T2DM (DCRC group, n = 12), CRC patients without diabetes (CRC group, n = 12), and healthy controls (Health group, n = 12). We analyzed the fecal microbiomes, characterized the composition and function based on the metagenomics of DCRC patients, and detected the short-chain fatty acids (SCFAs) and bile acids (BAs) levels in all fecal samples. Finally, we performed a correlation analysis of the differential bacteria and metabolites between different groups.@*RESULTS@#Compared with the CRC group, LefSe analysis showed that there is a specific GM community in DCRC group, including an increased abundance of Eggerthella , Hungatella , Peptostreptococcus , and Parvimonas , and decreased Butyricicoccus , Lactobacillus , and Paraprevotella . The metabolomics analysis results revealed that the butyric acid level was lower but the deoxycholic acid and 12-keto-lithocholic acid levels were higher in the DCRC group than other groups ( P < 0.05). The correlation analysis showed that the dominant bacterial abundance in the DCRC group ( Parvimonas , Desulfurispora , Sebaldella , and Veillonellales , among others) was negatively correlated with butyric acid, hyodeoxycholic acid, ursodeoxycholic acid, glycochenodeoxycholic acid, chenodeoxycholic acid, cholic acid and glycocholate. However, the abundance of mostly inferior bacteria was positively correlated with these metabolic acid levels, including Faecalibacterium , Thermococci , and Cellulophaga .@*CONCLUSIONS@#Unique fecal microbiome signatures exist in CRC patients with T2DM compared to those with non-diabetic CRC. Alterations in GM composition and SCFAs and secondary BAs levels may promote CRC development.
Subject(s)
Humans , Gastrointestinal Microbiome/genetics , Diabetes Mellitus, Type 2 , Microbiota , Bacteria/genetics , Fatty Acids, Volatile , Colorectal Neoplasms/metabolism , Butyrates , Feces/microbiologyABSTRACT
Objective:To compare the consistency and difference of non-mydriatic two-field 45° ultra-wide field Optos and Clarus500 fundus imaging in a large-scale diabetic retinopathy (DR) screening.Methods:A diagnostic methodology study. From November 2020 to August 2021, 526 eyes of 277 patients with type 2 diabetes who diagnosed in Department of Ophthalmology, Henan Provincial People's Hospital were included in the study. Among them, there were 175 males with 328 eyes and 102 females with 198 eyes; the age was 53±10 years old. The same experienced technician performed the non-mydriatic dual-field 45° fundus imaging and the non-mydriatic ultra-wide-angle imaging system Optos, Clarus500 single-field fundus imaging examination on the patient on the same day, and obtained the dual-field 45° fundus image and Optos, Clarus500 single-field fundus image. The Optos and Clarus500 single-field fundus images in the same area as the dual-field 45° fundus image were captured by Photoshop software, and the Optos and Clarus500 dual-field fundus images were obtained. Subsequently, two experienced ophthalmologists performed interpretation and DR grading of the 5 groups of images, respectively. Images with inconsistent grading results were interpreted by a third ophthalmologist and used as the final grading result. In order to avoid the mydriatic dual-field 45° imaging interpretation results as the standard, the consistency and detection rate difference of the two ultra-wide-angle imaging systems in the rapid DR screening results were evaluated. The weighted Kappa ( κ) test was used to analyze the consistency of DR diagnosis between dual-field 45° fundus imaging and Optos and Clarus500 fundus imaging; χ2 test was used to compare the detection rates of DR between different imaging systems. Results:Compared with the dual-field 45° fundus image, the Clarus500 single-field had a higher DR detection rate ( χ2=24.965, P<0.001), and the Optos dual-field fundus image had a lower DR detection rate ( χ2=49.559, P<0.001). Compared with the DR detection rate of dual-field 45° fundus image, Optos single-field fundus image, Clarus500 double-field fundus image had no significant difference ( χ2=2.572, 0.649; P=0.109, 0.421). Compared with Optos, Clarus500 single-field and dual-field fundus images DR detection rate, the difference was statistically significant ( χ2=43.214, 61.216; P<0.001). Consistency assessment of DR grading results: dual-field 45° fundus images and Clarus500 dual-field fundus images ( κ value=0.932, 95% confidence interval ( CI) 0.907-0.956) were highly consistent; dual-field 45° fundus images and Optos single-field fundus images [ κ value=0.474, 95% CI 0.417-0.532], Optos dual-field fundus image ( κ value=0.495, 95% CI 0.438-0.551), Optos dual-field fundus image ( κ value=0.495, 95% CI 0.438-0.551) and Clarus500 dual-field fundus image ( κ value=0.452, 95% CI 0.395-0.506) were moderately consistent; dual-field 45°fundus images and Clarus500 single-field fundus images ( κ value=0.354, 95% CI 0.303-0.403) and Optos single-field fundus images and Clarus500 single-field fundus images ( κ value=0.347, 95% CI 0.287-0.393) showed general agreement. Conclusions:Compared with Optos dual-field fundus image, dual-field 45°fundus image and Clarus500 dual-field fundus image have high consistency in the grading results of DR rapid screening. Compared with Optos single-field fundus image, the detection rate of the DR of Clarus500 single-field fundus image is higher.
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Objective To explore the CT features of primary retroperitoneal liposarcoma.Methods A retrospective analysis of pathologically confirmed primary retroperitoneal liposarcoma was done.Results Tumors were located in left retroperitoneal space in 16 cases,in right retroperitoneal space in 10 cases,and in median retroperitoneal space in 3 cases.The maximum diameter ranged from 9-40 cm,with an average of (17 ±8) cm.Tumors were round in 8 cases,oval in 10 cases and irregular in 11 cases.The boundary of tumor was clear in 10 cases.CT plain scanning was mixed density in 20 cases,uniform density in 9 cases;Tumors of necrotic cysts in 11 cases,and with calcification in 9 cases;Enlarged intraperitoneal and retroperitoneal lymph nodes were found in 6 cases and intrahepatic metastases in 3 cases.The solid part was mild to moderate enhancement.Pathologically of the 29 cases,7 were dedifferentiated,4 were mucous,5 were polymorphic,1 1 were well differentiated and 2 were mixed.Conclusion The CT examination of primary retroperitoneal liposarcoma is of great value in locating tumor and judging the relationship between tumor and adjacent organs.
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Objective To investigate CT and MRI features of hepatoblastoma in adults.Methods CT and MRI findings of 8 cases of adult hepatoblastoma were retrospectively analyzed.Results (1) 75.0％ of the tumors was located in the right lobe of the liver and 25.0％ in the left lobe of the liver.(2) The maximum diameter of the tumor was averaged at (8.2±5.5)cm,and the maximum diameter of ＞ 5 cm was 62.5％.(3) Most tumors have a complete or incomplete false envelope,and the boundary is clear.(4) 75.0％ tumors were of necrocystic degeneration with calcification or bleeding in 25.0％ cases.(5) CT flat scan showing uniform low density or low density,MRI scanning T1WI was low signal,T2WI,T2WI fat suppression and DWI were high in parenchyma.(6) To strengthen substantial part in mild and moderate arterial uneven improved or ring slightly improved,portal venous phase continued mild reinforcement,delay slow exit accounted for 75.0％,reinforced psuedocapsule was mild.(7) The adjacent organs are under pressure deformation.(8) All patients underwent tumor resection and were followed up for 3 to 24 months.Conclusions CT and MRI characteristics of hepatblastoma in adult are specific and help improve the diagnostic accuracy of the disease.
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Objective@#To investigate the clinical significance of scheduled diclofenac sodium in gynecological hysteroscopic surgery.@*Methods@#A total of 125 patients undergoing hysteroscopic surgery were divided into observation group(64 cases) and control group(61 cases) according to the operation date.The observation group received diclofenac sodium(50mg) 30min before operation and after operation.The control group was anesthetized with propofol 2mg·kg-1·h-1.The pain at 1h and 2h postoperatively, the incidence of adverse reactions within 12h after operation, the time from operation to bed ambulation, anesthetic cost and comfort of patients were compared between the two groups.@*Results@#The pain scores of VAS in the observation group at 1h and 2h postoperatively were (3.23±1.75)points and (1.84±1.36)points, respectively, which were significantly lower than those in the control group[(5.07±1.73)points and (2.75±1.60)points, t=-5.875, -3.435, all P<0.05]. The incidence of nausea and vomiting in the observation group within 12h after operation was less than that in the control group(5 cases vs.27 cases)(χ2=12.175, P<0.05). The time spent on ambulation of the observation group[(11.17±2.18)min]was significantly shorter than that of the control group[(17.84±3.42)min](t=-12.933, P<0.05). The anesthetic cost of the observation group was significantly lower than that of the control group (1.24 CNY vs.71.30 CNY, t=18.130, P<0.05).@*Conclusion@#The diclofenac sodium plan anal preoperative analgesic effect in patients undergoing gynecological hysteroscopic surgery is better, so that out of bed activities ahead of time, can reduce the anesthesia costs, gynecological hysteroscopy can be used as the preferred method of anesthesia.
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Objective To investigate the CT features of early infection stage of thoracic and pulmonary paragonimiasis. Methods Medical records of 56 patients with thoracic and pulmonary paragonimiasis from January 2010 to June 2017 were collected, and the patients were diagnosed and treated at Yongjia County People's Hospital, and the results of laboratory examination and CT imaging features were analyzed retrospectively. Results The absolute value of eosinophils in peripheral blood of 56 patients was (5.61 ± 3.18) × 109/L, and the percentage of eosinophils was (35.90 ± 19.16)％, all of which increased to varying degrees. Forty-two patients had different degrees of pleural effusion and 52 cases with lung lesions. Lung lesions demonstrated one or several kinds of foci at the same time, randomly distributed in the lung field, mostly located in the sub-pleural lung tissue. There were 12 cases with pulmonary ground glass shadow, 4 cases with peribronchitis, 31 cases with pulmonary invasive lesions and 28 cases with pulmonary nodular/strip shadow. The size of most nodules were 0.5 - 1.0 cm, accompanied with halo sign. Conclusions The CT features of early infection stage of thoracic and pulmonary paragonimiasis are diverse. The size of 0.5 - 1.0 cm lung nodules with halo sign has certain characteristics in the diagnosis of paragonimiasis. Peribronchitis, infiltrative lesions, pleural effusion and increased peripheral blood eosinophil percentage can suggest diagnosis.
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Objective To summarize the computed tomography (CT) characteristics of primary hepatic angiosarcoma (PHA).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 9 PHA patients who were admitted to the Wenzhou Chinese Medicine Hospital (3 patients),Second Affiliated Hospital of Wenzhou Medical College (3 patients) and Wenzhou People's Hospital (3 patients) between January 2006 and June 2017 were collected.All 9 patients were fasting 8 hours before CT examination,and received screen scans without abdominal pressure.Scanning area was from dome of diaphragm to lower pole of the kidneys.Two associate senior doctors made images analysis.After preoperative examinations,patients selected whether or not to undergo treatment,resection,liver transplantation or chemotherapy + targeted therapy of monoclonal antibodies.Observation indicators:(1) plain scan appearances of CT;(2) enhanced scan appearances of CT;(3) results of pathological examinations;(4) follow-up and survival situations.Follow-up using outpatient,inpatient and imaging examinations was performed to detect tumor recurrence and stable condition up to December 2017.Results (1) Plain scan appearances of CT:9 patients showed solitary tumor,and tumors were respectively located in the left lobe (3 cases) and right lobe (6 cases) of the liver,including 5 with round tumors,3 with oval tumors and 1 with patchy tumor.The maximum diameter of tumor was 5.8-16.0 cm,with an average of 10.8 cm,including maximum diameter ＞ 6.0 cm in 8 patients.Tumors of 9 patients showed low-density shadow,and CT value was 32-46 HU,with an average of 41 HU,including homogeneous density in 3 patients and heterogeneous density in 6 patients;clear tumor boundary in 6 patients and unclear tumor boundary in 3 patients;tumor necrosis and cystolization in 4 patients,slightly strip-shaped high-density shadow in the center of tumor in 4 patients,and small patch-shaped intratunoral calcification in 1 patient.(2) Enhanced scan appearances of CT:① Arterial phase:tumors of 9 patients showed mild and moderate heterogeneous enhancements,with CT value of 63-76 HU and an average of 68 HU,including small patch-shaped or nodular enhancement in 3 patients and punetate or flocculent enhancement in the center of tumor in 6 patients.Tumors of 4 patients showed moderate enhancements,and tumor density was higher than that of normal liver parenchyma.Tumors of 5 patients showed mild enhancements,and tumor density was equal to or slightly less than that of normal liver parenehyma.② Portal vein phase:tumors of 9 patients showed mild and moderate,continuous and progressive enhancements,with a heterogeneous density,CT value of 56-71 HU and an average of 63 HU,including extended enhancement region in 3 patients,with a fusion and filling trend;small patch-shaped or nodular and lattice network-shaped enhancements of center and periphery of tumor in 6 patients,showing center filling and enhancement features of hepatic angiosarcoma.Tumors of 2 patients showed moderate enhancements,and tumor density was higher than that of normal liver parenchyma;tumors of 7 patients showed mild enhancements and tumor density was equal to or slightly less than that of normal liver parenchyma.③ Delayed phase:tumor enhancements of 9 patients slowly seceded,with CT value of 50-60 HU and an average of 53 HU,including density decreasing of periphery of tumor in 3 patients;partial fusion and center filling of enhancements in 6 patients,without enhancement in necrotic area.Tumor density was slightly higher than that of normal liver parenchyma in 2 patients,equal to that of normal liver parenchyma in 1 patient,and slightly less than that of normal liver parenchyma in 6 patients.(3) Results of pathological examinations:① Pathological examinations:cut surface of tumors showed grayish yellow and drab gray,and parts of surface were fish flesh shape,with internal bleeding and necrosis.Tumors were found in diffuse hyperplasia under microscopy,tumor tissues were made up of irregular and mutual matching lacuna vasorum,with infiltrating growths along hepatic sinus gap;hepatic angiosarcoma cells were spindle,round or irregular;there were slightly eosinophilia cytoplasm and deep chromatin of the nucleus,long-shaped or irregular nucleus,and different sizes of nucleolus.② Immunohistochemical staining:CD31 and CD34 were strongly positive,vimentin and Nestine were positive,and CK19,actin and creatine kinase were negative.(4) Follow-up and survival situations:of 9 patients,3 without treatment respectively died at 3,6 and 7 months;2 had recurrence at 4 and 5 months after tumor resection,with angiosarcoma invading right renal capsule,diaphragm and right pleural hemorrhage induced to haemothorax,and survived respectively for 13 and 15 months;2 respectively died of systemic metastasis at 4 and 8 months after liver transplantation;2 underwent chemotherapy + targeted therapy of monoclonal antibodies,and survived for 12 months.Conclusions CT appearances of PHA have certain characteristics.The plain scans of CT show heterogeneous low-density shadow,and enhanced scans of CT show small patch,punctate or nodular-shaped,continuous and progressive enhancements,with a clear boundary between tumor and liver parenchyma.
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Objective To compare the detection performance of the modified serum test (TRUST) method and the traditional method in syphilis screening.Methods A series of TRUST high titer syphilis serum was diluted,and the positive rate of each method was calculated by using the improved method and the traditional method.Comparison of two detection methods of C50,C5 ～ C95 interval,as well as the accuracy of the density curve,and the consistency of the two methods were compared,and diagnostic performance were compared.Results The improved method of C50 was less than the traditional method of C50,and the improved method of C5 ～ C95 range was narrower than the traditional method,compared with the traditional method.The improved method of the non precision density curve was steeper than the traditional method,and the two confidence interval of the consistency degree of the 95％ methods was 73.4％ to 95.8％.The diagnostic sensitivity (SEN),diagnostic specificity (SPE),positive predictive value (PPV),negative predictive value (NPV) and diagnostic efficiency(DF) of the improved method were 64.29 ％,99.1％,85.71％,97.05 ％ and 96.39 ％,respectively.The SEN,SPE,PPV,NPV and DF of the traditional methods were 3.75 ％,98.49 ％,75 ％,96.18 ％ and 95 ％,respectively.The improved method was superior to the traditional methods in the two aspects of SEN and PPV (x2 =8.25,10.03,all P＜0.05),with the statistically significant difference.The improved method was slightly higher than the traditional method in SPE,NPV and DF (x2 =2.39,3.45,4.03,all P＞0.05),with the no statistically significant difference.Conclusion The precision,diagnostic sensitivity and diagnostic specificity of the improved method was higher than that of the traditional method,and it can be applied to the detection of large batch samples with the aid of the full automatic enzyme immunoassay instrument.The improved method can be used to replace the traditional method for syphilis screening.
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To investigate the CT appearances in early stage of clustering lung paragonimiasis,9 cases of two clustering lung paragonimiasis caused by eating raw stone-crab and laboratory examination were included in the study.Eight cases consulted by doctors in the hospital and their appearances were retrospectively analyzed.There were pleural effusion of varying degree (n=8) and random distribution sub-pleural pulmonary infiltrative lesions (n=7).The accompany appearances of the latter had lunar halo sign,characteristic tunnel sign (n=1) and peri-bronchitis (n=1).If CT detects pulmonary infiltrative lesions of random distribution within sub-pleura or tunnel sign,combining with the history of eating raw stone crabs and other freshwater fishes,with the rise of eosinophilic granulocytes in peripheral blood,the diagnosis of paragonimiasis should be suggested.
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Objective To fully grasp the epidemic situation of drinking water type of endemic fluorosis in Jiaozuo City of Henan Province,evaluate the efficacy of the prevention and control measures,and to provide a basis for prevention and control of the disease.Methods According to "The Measures for Control and Elimination of Key Endemic Diseases",all the diseased villages in Jiaozuo City were investigated.For all diseased villages in accordance with the improved water or no improved water,drinking water samples were collected,the fluorine content in water samples was determined based on the standard testing method for drinking water (GB/T 5750.5-2006);all children aged 8 to 12 years old of the surveyed villages were examined and determined dental fluorosis using "Diagnostic of Dental Fluorosis" (WS/T 208-2011);all evaluations were based on the criteria for drinking water-based fluorosis control (National Health Control [2014] No.79).Results Totally 7 counties (cities) 59 townships 589 diseased villages were surveyed in the city,586 diseased villages had improved the water quality,the rate was 99.49％,the number of villages that used the water facility normally was 571,the normal utilization rate was 97.44％,and there were 15 villages with excessive fluoride in water.A total of 35 057 children aged 8 to 12 years old in the diseased villages of the city were examined and 13 846 cases were detected dental fluorosis,the detection rate of dental fluorosis was 39.50％,the index of dental fluorosis was 0.65,which was a moderate epidemic;147 villages reached the control of standard among the 586 diseased villages with improved water,and the compliance rate was 25.09％,and the 7 drinking water type local fluoride poisoning epidemic counties (cities) in the area all did not reached the control standards.Conclusion Totally 439 diseased villages in the city have not meet the control standard,we should strengthen the monitoring,implement measures to improve water quality,strengthen the management and maintenance of water projects to ensure that the disease affected population to have qualified drinking water in a long-term,and gradually achieve the target to control and eliminate city's drinking water type of endemic fluorosis.
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Objective To assess the clinical efficacy of foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities.Methods During the period from February to July 2011,we retrospectively analyzed 20 patients with varicose veins of the lower extremities,who were treated with lauromacrogol foam sclerosing agent injected directly at varicose veins,and in 5 extremities injected at the great saphenous vein(GSV) through a catheter at the same time.Elastic bandages were applied at the site of the injected varicosities after the therapy.The clogging of the varicose veins,the improvement of the clinical symptoms and the adverse reaction were observed. Results Lauromacrogol foam sclerosing agent was successfully injected under the guidance of fluoroscopy in 20 patients with 28 affected extremities. The average volume of foam sclerosing agent in each affected extremity was 7.8 ml. All patients presented selflimiting minor complications,including swelling and pain,which was obviously alleviated by the externallyapplied Mucopolysaccharide Polysulfate Cream.Two patients presented cough that was relieved after inhaling oxygen. Most of treated varicosities demonstrated pigmentation after the first week, which gradually disappeared after the four-month use of vitamin E capsule.A second foam sclerotherapy was carried out for 3 affected extremities of 3 patients two months after the first therapy. Two cases of leg venous ulcer were healed within a few weeks.All patients could walk immediately with no deep vein thrombosis,pulmonary embolism,anaphylaxis,or transient visual disturbance. Obvious abnormal varicose veins as well as the soreness and fatigue of the lower extremities disappeared in all patients at the 10th-month follow-up.The grading of the disease was significantly improved by the treatment (Z =5.103,P ＜ 0.01 ).Conclusions The efficacy of lauromacrogol foam sclerosing agent in the treatment of varicose veins of the lower extremities is confirmed,with advantages of lower complication,ease of treatment,repeatability,and outpatient treatment.the filling-defects technique under fluoroscopy is a method for tracing the sclerosing foam,and can effectively prevent the decp vcin thrombosis.