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Urine cell-free DNA (ucfDNA) contains DNA fragments released from the lysis of cells in the urinary system, and circulating cell-free DNA (ccfDNA) can also enter the urine after glomerular filtration, and the mutation information carried by tumor DNA contained in ucfDNA and ccfDNA is consistent. Therefore, as a biomarker for molecular diagnosis of urological and non-urinary tumors, ucfDNA, has become a research hotspot in the field of liquid biopsy in recent years. UcfDNA has potential application value in individualized treatment, early diagnosis, dynamic monitoring of therapeutic efficacy, and prognosis assessment, etc. However, in order to realize the clinical application of urine ucfDNA, the extraction and accurate detection of ucfDNA still need to be solved.
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OBJECTIVE:To provide reference for hospital infection treatment and control. METHODS:The etiological data of Enterococcus isolated from clinical specimens were collected from our hospital during Jan. 2009-Jun. 2017. The drug resistance of commonly used antibiotics and infection related risk factors were analyzed retrospectively. RESULTS:A total of 6252 isolates of Enterococcus were isolated,of which there were 1994 strains of E. faecalis and 3575 strains of E. faecium. The bacteria were mainly isolated from urine(2009 strains),drainage liquids(1538 strains),bile(1168 strains),wound secretions(561 strains), blood (493 strains). The detection rate increased 9.4％ in 2009 to 13.4％ in 2017. Resistance rate of E. faecalis to ampicillin, penicillin and vancomycin showed a wavelike decrease,and E. faecalis showed low resistance rate to vancomycin,teicoplanin, linezolid and tigecycline. Resistance rate of E. faecalis to ciprofloxacin,moxifloxacin and levofloxacin decreased wavily to 2014 but showed a fluctuating upward trend since 2015. Resistance rate of E. faecium to linezolid decreased from 1.9％ in 2009 to 0.2％ in Jun. 2017;resistance rate of E. faecium to vancomycin and teicoplanin continues to fluctuate,but it is still at a low level;resistance rate of E. faecium to tetracycline decreased, but that to high concentration gentamicin increased. There were 43 strains of vancomycin-resistant E. faecium and 8 trains of vancomycin-resistant E. faecalis detected in 51 patients. Resistant rates of vancomycin-resistant E. faecium to linezolid,tigecycline and teicoplanin were 23.3％,0,35.3％,respectively. Resistant rates of vancomycin-resistant E. faecalis to linezolid,tigecycline and teicoplanin were 0. Pearson relationship analysis showed that days in ICU (r=0.225,P<0.01),tracheotomy or intubation (r=0.314,P<0.01),days of antibiotic use (r=0.347,P<0.01),types of antibacterial drugs (r=0.226,P<0.01),use of glucocorticoids (r=0.190,P<0.01),and days of carbapenems use (r=0.173,P<0.05)were positively correlated with vancomycin-resistant E. faecium infection rate and vancomycin-resistant E. faecalis infection rate. CONCLUSIONS:The detection rate of Enterococcus in our hospital is fluctuating upward. E. faecalis and E. faecium were the main types,mainly from urine and drainage fluids. The resistance rate of Enterococcus most of antibiotics shows a downward trend. The resistance rate of E. faecium to high concentration gentamycin is on the rise,while that of E. faecium to linezolid and tetracycline is decreased. The appropriate antibiotics should be selected according to the patient's condition and drug susceptibility results.
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Objective To investigate the therapeutic efficacy of the combined therapy of daoyin prescription and cognitive training on vascular dementia(VD).Methods Totally 75 patients with VD were randomly divided into 3 treatment groups:daoyin prescription,cognitive training and two combined treatments(n =25 each) for 3 months.Mini mental state examination(MMSE),Loewenstein occupational therapy cognitive assessment(LOTCA)and activities of daily living scale(ADL)were used for assessing therapeutic efficacy among three treatment groups.Results There were no significant differences in baseline clinical data among the three groups (P ＞ 0.05),possessing data comparability.Scores of MMSE,LOTCA,ADL and LOTCA subitems of orientation,visual perception,spatial perception,visual movement,thinking operation and attention were significantly improved in the 3 groups after 3 months intervention versus pre-treatment with three treatments(all P＜0.01).There were significant differences in scores of MMSE,LOTCA,ADL and LOTCA subitems of orientation,visual perception,visuo-motor organization and attention between combination therapy group versus daoyin prescription group and cognitive training group (all P ＜ 0.05).Conclusions Combined treatments of daoyin prescription and cognitive training have better effect on vascular cognitive function in patients with and VD.It can markedly improve the activities of daily living and cognitive function.It is worthy of further research in clinical medicine.
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Objective To explore the feasibility and efficacy of windowing middle meatus maxillary sinus and the frontal recess of tears to treat complex maxillary sinus under the nasal endoscope.Methods Clinical data of 22 patients with complex maxillary sinus lesions were analyzed retrospectively,which were adopted by the approach surgical treatment of through windowing middle meatus maxillary sinus and the frontal recess of tears.In which varus papilloma in 11 cases,5 cases of fungal maxillary sinusitis,3 cases of hemorrhagic and necrotic polyps,recurrent nasal polyps in 3 patients.After operation,they were all taken CT or MRI examination.Nasal cavity and other sinus lesions were first removed,the maxillary sinus ostium were opened through the nasal passages.Then,the maxillary sinus lesions were removed by the frontal recess of tears operation.Results Through the treatment of postoperative nasal cavity irrigation,these cases were followed up for 6 to 18 months.All cases incisions were healed completely,sinus cavity epithelium and clinical symptoms disappeared gradually.No injuries of nasolacrimal duct and complications such as facial numbness.Conclusion The method of the nasal passages joint the frontal recess of tears to treat the complex maxillary sinus benign lesions is a worthy selection of surgical procedures.Its eye shot is open and convenient operation,it can remove maxillary sinus lesions thoroughly and has fewer complications.
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OBJECTIVE:To provide reference for clinical use and revision of drug instruction manual. METHODS:The ambi-guity in drug instructions manual was summarized and countermeasures of revision were presented based on the practical clinical conditions. RESULTS & CONCLUSIONS:The problems of drug instruction manual that may mislead the patients and medical per-sonnel were as follows as controversial main contents,unclear descriptions of instruction,unfocused contents or without key points,one instruction for multiple drugs,obvious or inaccurate translations,words without popularity and standardization and wrong sentence division or non-standard typesetting. It is suggested that the manufacturers should attach highly importance to the re-vision of drug instruction manual;the revisers should understand the meaning of drugs instruction manual and know the subjects;the premarketing instructions should be tested and investigated by necessary persons;the major and cultural quality of revisers should be improved;the approval monitoring should be strengthened and the feedback mechanism should be established to further improve the instructions,guide the medical staff and patients with accurate use of drugs and ensure the safe drug use of patients.
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Objective To explore the efficacy of modified uvula palatopharyngeal plasty in the treatment of obstructive sleep ap-nea syndrome(OSAHS) .Methods 145 cases of OSAHS patients were treated from June 2006 to June 2010 in our hospital ,of which 54 were treated by traditional UPPP surgery ,and the remaining 91 cases were treated by h-UPPP surgery .Compared its effi-cacy by the preoperative and postoperative polysomnography map (PSG) analysis .Results In 145 cases of patients with OSAHS , the PSG monitoring indicators of 1 year after surgery were compared with preoperative ,and there were significant difference in the apnea total time(AI) ,the breathing hypopnea index(AHI) ,the lowest oxygen saturation(SaO2 )(P<0 .05) .The subjective symp-toms in postoperative recovery process of modified UPPP ,such as dry throat ,open nasal ,nasopharyngeal reflux symptoms were sig-nificantly reduced than that of traditional UPPP surgery .Conclusion h-UPPP surgery have a good effect .
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OBJECTIVE@#To investigate the clinical feature, diagnosis, treatment and prognosis of primary nasal cavity-nasal sinuses T/NK cell lymphoma.@*METHOD@#Twenty-six patients with primary nasal cavity-nasal sinuses T/NK cell lymphoma were retrospectively analyzed. They were treated from January 2003 to December 2005.@*RESULT@#In this case, there were 17 males and 9 females, ranging from 16 to 68 years old. The clinical symptoms included rhinostegnosis, rhinorrhea and epistaxis, intumescence, pain, fever and so on. These tumors showed extensive soft tissue and bone invasion, necrosis and ulceration. The pathological diagnosis and immunohistochemical tests were performed in 26 cases and 21 cases respectively. Nineteen of these patients died, and the duration from onset to death ranged from 2 to 28 months.@*CONCLUSION@#The primary nasal cavity-nasal sinuses T/NK cell lymphomas are a distinct category of the non-Hodgkin's lymphoma (NHL). They appear to carry a high malignancy and pursue a aggressive course. They are easy to be misdiagnosed. The prognosis is not satisfactory, and the therapy should be given as early as possible.