A clinical analysis of children with invasive pulmonary fungal infections after biliary atresia surgery / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of invasive pulmonary fungal infections (IPFIs) after biliary atresia (BA) surgery and related risk factors.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 49 children with IPFIs after BA surgery, including clinical features, lung imaging findings, and pathogenic features. The risk factors for IPFIs after BA surgery were also analyzed.</p><p><b>RESULTS</b>The most common pathogens of IPFIs after BA surgery was Candida albicans (17 strains, 45%), followed by Candida tropicalis (7 strains, 18%), Aspergillus (6 strains, 16%), Candida krusei (3 strains, 8%), Candida glabrata (3 strains, 8%), and Candida parapsilosis (2 strains, 5%). Major clinical manifestations included pyrexia, cough, and shortness of breath, as well as dyspnea in severe cases; the incidence rate of shortness of breath reached 78%, and 35% of all children had no obvious rale. The multivariate logistic regression analysis showed that age at the time of surgery, time of glucocorticoid application, cumulative time of the application of broad-spectrum antibiotics, and recurrent cholangitis were major risk factors for IPFIs after BA surgery.</p><p><b>CONCLUSIONS</b>The three most common pathogens of IPFIs after BA surgery are Candida albicans, Candida tropicalis, and Aspergillus. It is important to perform surgery as early as possible, avoid recurrent cholangitis, and shorten the course of the treatment with broad-spectrum antibiotics and glucocorticoids for decreasing the risk of IPFIs.</p>

Kuntai capsule combined with gonadotropin releasing hormone agonist in treatment of moderate-severe endometriosis: a clinical observation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Kuntai Capsule (KC), a Chinese patent medicine, in add-back therapy for gonadotropin-releasing hormone agonist (GnRH-a) treatment for moderate-severe endometriosis (EM).</p><p><b>METHODS</b>Totally 100 patients suffering from stage III/IV EM, who were confirmed by laparoscopic surgery were randomly assigned to the GnRH-a group (A) and the KC combined GnRH-a group (B), 50 in each group. Patients in Group A were hypodermically injected with goserelin (3.6 mg), once per 4 weeks. Those in Group B additionally took KC, 4 pills each time, three times per day. The therapeutic course for all was 12 weeks. Serum levels of estradiol (E2), follicle stimulating hormone (FSH), bone gamma-carboxyglutamic-acid-containing proteins (BGP) were measured respectively. Kupperman Menopausal Index (KMI) and bone mineral density (BMD) of the lumbar vertebra were also compared between the two groups.</p><p><b>RESULTS</b>Serum levels of E2 and FSH both significantly decreased in the two groups at week 12 of the treatment (P < 0.05), when compared with pre-treatment. Compared with before treatment in the same group, KMI increased in the two groups (P < 0.05). Compared with before treatment in the same group, BMI decreased in the two groups with no statistical difference (P > 0.05). Serum BGP increased after 12-week treatment (P < 0.05). Compared with Group A after treatment, serum levels of E2 and FSH both significantly increased in Group B (P < 0.05). There was no statistical difference in KMI between the two groups (P > 0.05). As for the incidence of menopausal symptoms, better effects in improving symptoms such as hot flashes, sleep disorders, and vaginal dryness were obtained in Group B than in Group A (P < 0.05). There was no significant difference in the post-pre-treatment difference of BMI between the two groups, but with statistical post-pre-treatment difference in the BGP level (P < 0.05).</p><p><b>CONCLUSIONS</b>HKC combined GnRH-a could effectively reduce GnRH-a treatment induced partial low estrogen symptoms, improve increased serum BGP levels after GnRH-a therapy.</p>

Magnetic resonance spectroscopic imaging with only surface coils for diagnosing prostate cancer / 第二军医大学学报

Objective To study the value of magnetic resonance spectroscopic imaging (MRSD with only surface coils in diagnosing prostate cancer. Methods A total of 48 elderly patients with surgery or biopsy-confirmed benign prostatic hyperplasia or prostate cancer were preoperatively examined by surface coils for three-dimensional simple multi-voxel magnetic resonance spectroscopy scans, and the voxel (choline[Cho] + creatine[Cr])/citrate(Cit) values were calculated. According to the pathological findings, the voxels were divided into prostate cancer and non-cancer. The voxel (Cho + Cr)/Cit values of prostate central zone and prostate peripheral zone were analyzed. The voxel nature of (Cho+Cr)/Cit value was used as the gold standard receiver to plot characteristic curve (ROC curve) and to calculate the area under the curve; the maximal Youden index was used as the standard to obtain the cut-off value and the corresponding sensitivity and specificity. Results The voxel (Cho + Cr)/Cit values of different natures were significantly different (P<0. 001). When the area under the ROC curve of (Cho + Cr)/ Cit value was used for diagnosis of prostate cancer, the central zone was 0. 652, and the peripheral zone was 0. 821. For the cutoff value, the central zone was (Cho + Cr)/Cit = 0. 645, with the corresponding sensitivity and specificity being 0. 512 and 0. 71, respectively; the peripheral zone was (Cho + Cr)/Cit = 0. 815, with the corresponding sensitivity and specificity being 0. 72 and 0. 84, respectively. Conclusion Surface coil alone can successfully complete the three-dimensional proton spectroscopic imaging of prostate, and (Cho + Cr)/Cit = 0. 815 for the cut-off value has a high diagnostic value for peripheral zone prostate cancer.