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Objective:To investigate the effects of lung rehabilitation training combined with systematic expectoration training on rehabilitation of stroke in patients subjected to tracheotomy.Methods:Sixty patients with stroke subjected to tracheotomy who received treatment in Ningbo Rehabilitation Hospital, China between January 2018 and July 2019 were included in this study. These patients were randomly assigned to undergo either systematic expectoration training alone (control group, n = 30) or lung rehabilitation training combined with systematic expectoration training (observation group, n = 30) for 1 month. Therapeutic effect, number of daily sputum aspirations, blood oxygen saturation, maximum inspiratory volume, maximum expiratory volume, duration of infection control, duration of placement of indwelling tracheal catheter, and complications were compared between the two groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [90.0% (27/30) vs. 73.3% (22/30), χ2 = 5.092, P < 0.05]. Before treatment, there were no significant differences in the number of daily sputum aspirations, blood oxygen saturation, maximum inspiratory volume, and maximum expiratory volume between the two groups ( t = 1.139, 0.705, 0.253, 0.519, P > 0.05). After treatment, the number of daily sputum aspirations in the observation group was significantly lower than that in the control group [(2.16 ± 1.28) counts vs. (3.59 ± 2.39) counts, t = 5.616]. Blood oxygen saturation, maximum inspiratory volume, maximum expiratory volume in the observation group were (99.3 ± 0.5)%, (479.37 ± 64.15) mL and (482.23 ± 62.16) mL, respectively, which were significantly higher than those in the control group [(95.8 ± 0.7)%, (403.58 ± 62.13) mL, (398.37 ± 64.24) mL, t = 4.075, 4.279, 4.106, all P < 0.05]. The duration of infection control and the duration of placement of the indwelling tracheal catheter in the observation group were (15.21 ± 5.48) days and (23.39 ± 6.51) days, which were significantly shorter than those in the control group [(23.39 ± 6.51) days, (32.64 ± 6.16) days, t = 6.080, 5.119, both P < 0.05]. The incidences of pulmonary infection and gastroesophageal reflux in the observation group were 6.7% (2/30) and 6.7% (2/30), respectively, which were significantly lower than those in the control group [16.7% (5/30), 70.0% (21/30), χ2 = 4.071, 4.372, both P < 0.05]. The proportion of patients with respiratory muscle strength ≥ grade 4 in the observation group was significantly higher than that in control group [96.7% (29/30) vs. 70.0% (21/30), χ2 = 14.402, P < 0.05]. Conclusion:Lung rehabilitation training combined with systematic expectoration training can greatly promote the rehabilitation of stroke patients subjected to tracheotomy, improve respiratory function, reduce pulmonary infection, and is safe and reliable.
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Objective To evaluate the application of Burnet Institute-made prototype IgA rapid test,a kind of point-of-care (POC) testing,in the diagnosis of early syphilis.Methods Totally,455 stored serum samples in the Reference Laboratory of Sexually Transmitted Disease,the Institute of Dermatology were used to evaluate the application of the prototype IgA rapid test (IgA-POC) in the diagnosis of early syphilis.According to resluts of Treponema pallidum hemagglutination assay (TPHA),rapid plasma reagin card test (RPR),and enzyme-linked immunosorbent assay for IgM antibodies (IgM-ELISA),these stored samples were divided into 3 groups:uninfected group,previously infected group and early active syphilis group.IgA-POC test was performed in the 3 groups to evaluate its diagnostic performance for active syphilis,and researchers were blind to the group information.Results The prototype IgA-POC test had a sensitivity of 92.6％ (147/163) for the early active syphilis group,a specificity of 72.22％ (104/144) for the previously infected group,and a specificity of 97.97％ (145/148) for the uninfected group.The total specificity of the prototype IgA-POC test was 85.27％,which met the minimum requirement of WHO for the POC test.The prototype IgA-POC test showed a significantly higher sensitivity for the diagnosis of early active syphilis compared with the IgM-ELISA (59.51％,Z =6.88,P ＜ 0.05),but a significantly lower specificity for the diagnosis of previous syphilis infection compared with the IgM-ELISA (98.61％,Z =6.18,P ＜ 0.05).Moreover,no significant difference in the specificity for the diagnosis of non-infection was observed between the prototype IgA-POC test and IgM-ELISA (Z =1.16,P =0.25).Conclusion The prototype IgA-POC test has better capacity for the diagnosis of early active syphilis compared with the IgM-ELISA,so it can be applied to the screening of early active syphilis.
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Objective To investigate the application value of ultrasonography in the differential diagnosis of benign and malignant thyroid nodules in the elderly.Methods The ultrasonography data of 117 elderly patients with thyroid nodules confirmed by surgery and pathology were analyzed retrospectively from Jan.2013 to Feb.2015.Their sonogram features were summarized.Results Among 117 cases,there were 82 cases (70.1 ％) with benign thyroid nodules and 35 cases (29.9％) with malignant thyroid tumors according to pathological diagnosis.The accordance rate of ultrasonography for diagnosing the benign and malignant thyroid nodules was 88.0％,and only 14 cases were misdiagnosed.Conclusions Ultrasonography has a good application value in the differential diagnosis of benign and malignant thyroid nodules in the elderly.
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Objective To investigate the different effect among ropivacaine,bupivacaine,lidocaine on analgesia after harvesting grafts from the scalp in burn patients. Methods 84 patients who need harvesting grafts from the scalp after burn were divided in 4 groups random-ly(n=21). Patients in group C hypodermically injected with saline 200 mL were control,while patients in group R injected with 0. 05% ropi-vacaine 200 mL,group B with 0. 188% bupivacaine,and group L with 0. 1% lidocaine. Motor activity assessment scale( MAAS) and visual analogue scale(VAS) were made before anesthesia(T0) and 20 min,5 h,10 h after awake of patients. VAS were made focus on head and body in part. Vital signs were also monitored and recorded for assessment of security. Results All patients in 4 groups had passed the period of operation safely. Patients in group R have better VAS than other groups. Conclusion Low concentration ropivacaine hypodermically injec-tion of head is helpful to relieve the pain after harvesting grafts from the scalp.
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Objective To study the characteristics of IL-1B-31/-511 single nucleotide polymor-phisms (SNPs) and the variable number tandem repeat (VNTR) in intron 2 of the IL-1ra gene (IL-1RN) in patients with HCV-related liver diseases .Methods The concentration of IL-1βand IL-1ra in serum sam-ples was measured by ELISA assay .The SNPs of IL-1B gene (-31C/T,-511C/T) from 310 cases with HCV infection and 324 unrelated healthy controls were determined by using gene chip analysis , and the results for some randomly selected specimens were compared with those by using polymerase chain reaction -restriction fragment length polymorphism ( PCR-RFLP) assay.The VNTR polymorphism of IL-1RN intron 2 was ana-lyzed by PCR-RFLP assay.The serum level of alanine aminotransferase (ALT), an indicator of hepatocellu-lar injury, was detected by ROCHE cobas 8000 analyzer.HCV replication was measured by using specific fluorescence PCR .The genotypes of HCV were determined by direct nucleotide sequencing test .Results Compared with control group, the serum level of both IL-1β[(22.6 ±7.3) vs (13.7 ±4.2)] pg/ml and IL-1ra [(286.30 ±55.10) vs (185.55 ±48.32)] pg/ml were significantly increased in patients with HCV infection ( P0.05).The frequency of IL-1B-511TT genotype (P<0.05, OR=1.55, 95% CI =1.10-2.18) and IL-1B-511T allele (P<0.05,OR=1.31,95% CI=1.05-1.63) in patients with HCV infection were signifi-cantly higher than those in healthy controls .IL-1B-511C/T SNP showed a significant association with the outcomes of HCV infection (P<0.005).Compared with IL-1B-511CC and IL-1B-511CT, IL-1B-511TT was a major risk factor for mild and moderate Hepatitis C [ OR=2.17 ( 1.48-3.19 ) ] , severe Hepatitis C [OR=2.11(1.05-4.26)], cirrhosis [OR=2.98(1.77-4.99)] and HCC [4.33(2.16-8.67)].IL-1B-511 T allele was significantly associated with mild and moderate Hepatitis C [ 1.80 ( 1.38-2.36 ) ] , severe Hepatitis C [1.80(1.08-3.01)], cirrhosis [2.62(1.76-3.89)] and HCC [3.49(1.96-6.23)].The fre-quency of IL-1B-511T allele showed significant difference among each group (P<0.005).No association was found between any of the other polymorphisms and HCV infection .Conclusion The serum level of IL-1βand IL-1ra were significantly associated with HCV infection .IL-1B-511T allele in patients with HCV in-fection up-regulated the serum level of IL-1β.IL-1B-511TT and IL-1B-511T allele were major risk factors for mild and moderate Hepatitis C, severe Hepatitis C, cirrhosis and HCC, but IL-1B-511CC/C had oppo-site effects.
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Objective To make a nationwide external quality assessment of serologic tests for syphilis in China,in hope to increase the quality of syphilis serology in laboratories at different levels.Methods From 2006 to 2008,a nationwide external quality assessment scheme was conducted for serologic tests for syphilis in laboratories of some medical and healthcare facilities each year by the Reference Laboratory,National Center for Sexually Transmitted Disease Control,China Center for Disease Control and Prevention.Five quality control samples and corresponding questionnaires were sent to the participating laboratories.Tests were conducted and test results were reported within stipulated time.Subsequently,the test results were statistically analyzed by the Reference Laboratory,and the final results were fed back to all of these participants.Results From 2006 to 2008,the number of participating provinces increased from 17 to 31,and the number of participating laboratories from 23 to 145.Laboratories achieving a full score amounted to 79.9％,36.8％ and 57.6％,and those gaining a score of 80 or greater amounted to 95.7％,88.2％ and 89.7％,respectively,in 2006,2007 and 2008.Conclusion The external quality assessment scheme has enhanced the capacity of participating laboratories for syphilis serology to a certain extent from 2006 to 2008.
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Objective To estimate the prevalence of hepatitis C virus (HCV) infection among sexually transmitted disease (STD) clinic attendees infected with human immunodeficiency virus type 1 (HIV-1) in Guangxi Zhuang Autonomous Region.Methods Totally,11 553 blood plasma samples were collected from STD clinic attendees in Guangxi Zhuang Autonomous Region,and subjected to HIV-1 antibody screening and confirmatory testing.Enzyme linked immunosorbent assay (ELISA) was performed to detect anti-HCV antibodies in 140 anti-HIV-1 antibody-positive samples and 282 anti-HIV-1 antibody-negative samples from age-and marital status-matched attendees.Chi-square test was performed to assess the differences in the prevalence rate of HCV infection between anti-HIV-1-negative and-positive samples,and Logistic regression analysis to evaluate the risk factors for HCV and HIV co-infection.Results The positivity rate of anti-HCV antibodies was 33.57％ (47/140)among anti-HIV-1-positive samples,significantly higher than that in anti-HIV-1-negative samples (1.06％ (3/282),x2 =94.66,P ＜ 0.05).Logistic regression analysis showed a statistical increase in the prevalence of HCV/HIV co-infection in individuals reporting more than one sexual partners compared with those reporting only one sexual partner (OR =2.4,95％ CI (1.0-5.6),P =0.05),and in intravenous drug users compared with non-intravenous drug users (OR =20.8,95％ CI(5.7-76.5),P ＜ 0.05).Conclusions HCV infection appears to be associated with HIV-1 infection,and comprehensive intervention on HIV-1-infected patients may slow down HCV transmission.
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ObjectiveTo establish a rapid,sensitive and accurate method to detect Mycoplasma genitalium,and to evaluate the prevalence of M.genitalium among unlicensed prostitutes from Hezhou city in Guangxi Zhuang Autonomous Region.MethodsA pair of primers and Taqman MGB probe were designed and synthesized for the Pa gene of M.genitalium.Standard samples were prepared with the M.genitalium type strain G37.The established Taqman MGB real time fluorescence-based PCR assay was used to detect M.genitalium in the standard samples and cervical swab specimens collected from unlicensed prostitutes in Hezhou city of Guangxi Zhuang Autonomous Region.ResultsThe established Taqman MGB real time PCR exhibited a wide linear range( 1 × 10 copies/μl to 1 × 106 copies/μl,R2 =0.993),good repeatability(intra-assay variation;0.7％,inter-assay variation:1.09％) and hign sensitivity with the limit of detection being 10 copies/μl and limit of quantification being 50 copies/μl.As the assay showed,12.1％ of the 404 cervical swab samples were positive for M.genitalium.ConculsionThe Taqman MGB real time fluorescence-based PCR is a rapid and sensitive method for the quantitative and qualitative detection of M.genitalium.
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ObjectiveTo investigate the prevalence of syphilis among outpatients in sexually transmitted disease (STD) clinics in Guangxi Zhnang Autonomous Region,and to assess the socioeconomic and behavioral factors associated with the infection.MethodsThe outpatients to 14 STD clinics in 8 cities of Guangxi Zhnang Autonomous Region were investigated with questionnaires by their doctors at the first visit.Venous blood samples were obtained from these outpatients and subjected to toludine red unheated serum test (TRUST) to screen for syphilis.Treponema pollidum particle agglutination (TPPA) was performed for TRUSTpositive samples.The epidemiological data were collected by using EpiData software,statistically analyzed by using SPSS13.0 software package.ResultsA total of 10 930 STD outpatients were recruited in the study,and 1297 samples were confirmed to be both TRUST and TPPA positive.The prevalence of syphilis was 11.9％ in all of the outpatients,14.3％ in female outpatients and 10.3％ in male outpatients,13.3％ in the outpatients of Zhuang nationality,and 11.4％ in those of Han nationalily.Multivariate analysis showed that syphilis was independently related to female sex[odds ratio(OR) 2.23,95％ confidence interval(CI) 1.69 - 3.00,P＜0.01 ],low educaiion level (middle school:OR 1.70,95％ CI 1.11 - 2.62,P ＜ 0.05; primary school or illiteracy,OR 1.98,95％ CI 1.13 - 3.46,P＜0.05),annual income of more than 30000 Yuan (OR 1.91,95％ CI 1.18 -3.10,P ＜ 0.01 ),commercial sex workers or having multiple sexual partners(OR 1.54,95％ CI 1.16 - 2.06,P ＜0.01 ).ConclusionsSyphilis serology should be the routine test in STD clinical settings in Guangxi region,and the intervention should be enhanced to control the prevalence of syphilis in high-risk populations.
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ObjectiveTo evaluate the performance of a three-gene typing system in the determination of Treponema pallidum (Tp) genotypes.MethodsTo determine the genotypes of Tp,three targets were assessed,including the number of 60 base-pair repeats,restriction fragment length polymorphism(RFLP) pattem of tprEGJ gene after MseI digestion and the sequence of tp0548 gene.The DNA extracted from the Nichols strain of Tp served as the positive control,and that from the moist ulcer of patients with genital herpes and negative RPR or TPPA test results served as the negative control.To validate the typing method,clinical specimens were collected from the moist skin lesions of patients with primary or secondary syphilis,and subjected to the amplification of polA gene by PCR.The enhanced molecular typing system was used to determine the genotypes of Tp in Tp DNA-positive specimens.ResultsThe Nichols strain harbored a genotype of 14a/a.No amplification of any of the three target genes was found in the negative control.The arp gene,tprEGJ gene and tp0548 gene were amplified from 94.1％,91.2％ and 94.1％ of the 40 clinical specimens,and the genotype was successfully determined by the three-gene typing system for 91.2％ of the clinical Tp strains.The predominant type of arp,tprEGJ and tp0548 genes was 14 repeats,d and f,respectively in these clinical Tp isolates.ConclusionThe enhanced molecular tying method for Tp exhibits high sensitivity,specificity and discrimination potential.
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Objective To perform a nationwide external quality assessment for detection of Chlamydia trachomatis, and to improve the performance of laboratories in the detection of Chlamydia trachomatis. Methods Totally, 419 quality control samples were sent to tested laboratories, including 76 samples in 2007, 168 samples in 2008 and 175 samples in 2009. The laboratories were required to test the samples and report test results, within stipulated time, to the reference laboratory in National Center for Sexually Transmitted Disease (STD) Control, Chinese Center for Disease Control and Prevention. The reported results were statistically analyzed by the National Center for STD Control, who finally fed back the statistical results to all of the participants. Results The percentage increased from 84.93% in 2007 to 92.14% in 2009 for laboratories showing an 80% or more consistency with the reference laboratory in the detection of Chlamydia trachomatis from quality control samples (qualified), from 47.95% in 2007 to 70% in 2009 for those showing a 100% consistency (excellent), and dereased from 5.48% in 2007 to 0.71% in 2009 for those showing a consistency of lower than 60% (unqualified). The centralabs of provincial CDC and volunteer laboratories exhibited a satisfactory performance for the detection of Chlamydia trachomatis, while the performance of a small number of national STD surveillance sites needed to be increase. Conclusion The external quality assessment reveals a continuous improvement in the capability of detecting Chlamydia trachomatis in STD laboratories at different levels in China.
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Objective To detect the expression of interleukin (IL)-18 of the peripheral blood cells and IL-18 receptor α chain(IL-18Rα) on the surface of CD_3~+ cells in patients newly diagnosed as immune thrombocytopenia (ITP) before medication and to explore the roles of IL-18 and IL-18Rα in the development of ITP. Methods Eighteen out-patients or inpatients with acute ITP accepting treatment in Qilu Hospital were enrolled in this study and 15 matching healthy subjects were taken as control. Plasma IL-18 level was detected with enzyme linked immunosorbent assay (ELISA), the expression of IL-18Rα on CD_3~+ lymphocytes and total lymphoeytes were measured with flow cytometry; T-bet and GATA-3 mRNA were measured with reverse transcriptase polymcrase chain reaction (RT-PCR). Results The expression of IL-18 in acute ITP plasma was (468. 57 ± 141.62) ng/L and IL-18Rα on the surface of CD_3~+ cells and lymphocytes were (8.50 ±3. 16)% and (9. 16±2.98)% respectively. The levels of IL-18 and IL-18Rα were increased in active ITP patients as compared with those in the controls (P <0. 05). The levels of IL-18 mRNA (0. 12 ±0. 02) and T-bet mRNA (0. 07 ±0. 02) were significantly increased in patients with active ITP as compared with those in the controls (P <0.05), while GATA-3 mRNA (0.0039±0.0014) were significantly decreased in patients with active ITP (P < 0. 05). The balance between T-bet and GATA-3 was significantly disturbed in ITP. Conclusions Through the variation of the levels of gene and protein, our study showed that IL-18 and IL-18Rα might upregulate the expression of Th1-cytokines in ITP patients. It is also suggested that IL-18 has potential association with the development of ITP. Especially, it may provide a new treatment method for ITP by regulating the ratio of T-bet and GATA-3 and resuming the balance of Th1/ Th2.
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Objective To investigate the relationships of the serum level of interleukin-1β(IL-1β), the single nucleotide polymorphism(SNP) of IL-1B and interleukin-1 receptor antagonist (IL-1RN) genes with the gastric cancer or the gastric cancer infected by Helicobacter pylori(Hp). Methods The SNP of the IL-1B(-31C/T and -511C/T) was determined by gene chip and the variable number of tandem repeat(VNTR) of IL-1RN were detected by agarose gel electrophoresis. The sera level of IL-1β and the concentrations of IgG, IgM and IgA of Hp antibodies were measured by ELISA. Results The serum level of IL-1β increased significantly in patients with gastric cancer than that in control group(P<0.001). Hp infection was detected in 69.2% of 260 patients and 46.5% of 284 controls[P<0.001, odds ratio (OR)=2.59]. Frequency of genotype IL-1B-31TT or IL-1B-511TT in patients with gastric cancer were significantly higher than that in healthy controls (P<0.01, OR=1.95; P<0.05, OR=1.62), respectively. Frequency in Hp+ gastric cancer group was higher than that in Hp- group (P<0.05, OR= 2.00), and frequency of haplotype T-T in patients group was significantly higher than that in healthy control(χ2=4.45, P<0.05). The serum level [(802±148) ng/L] of IL-1β of the gastric cancer group was significantly higher than that of the control group [ (501±125) ng/L, P<0.01]. The serum level of IL-1β in patients with -31T or -511T allele was (845±156) ng/L or (871±148) ng/L, significantly higher than that without -31T [(555±116) ng/L] and -511T allele [(581±128) ng/L]. Furthermore, The serum level of IL-1β in Hp+ group with T allele were significantly higher than that in Hp- group (P<0.001). There was no association of IL-1RN gene and other IL-1B gene with gastric cancer or Hp+ gastric cancer. Conclusion IL-1B-31TT genotype was related to gastric cancer. IL-1B-511TT genotype was related to gastric cancer or with Hp+ gastric cancer. Both IL-1B-31T and -511T are associated with IL-1B gene. The haplotype T-T may be the genetic susceptible factor to gastric cancer.
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Objectives To investigate the infection and colonization of Mycoplasma genitalium and Ureaplasma urealyticum in different male populations, to explore the association of M. genitalium and U. urealyticum with nongonococcal urethritis (NGU) respectively. Methods A case-controlled, cross sectional study of four different male populations was performed, namely: NGU patients (G1), non-NGU subjects attending STD clinic (G2), men who had sex with men participating in a health education program (G3), and healthy volunteers (G4). Nested PCR and culture were used to detect U. urealyticum. Nested PCR and PCR product sequencing were applied to detect M. genitalium. Results The prevalence rates of M. genitalium in the four study populations were 25.0%(25/100), 6.4%(6/94), 5.5%(6/110) and 0% respectively. Significant difference was found between each two groups except G2～G3 with a p value of 0.80. By multivariate regression analysis, controlling for the age of first sex, new sexual partners, urethritis and condom use in the previous 3 months, M. genitalium was only associated with urethritis (P= 0.004, OR = 6.754, 95% CI 1.833～24.893). The direct sequencing of PCR products showed gene mutations, in comparison with the reference sequence in GenBank, in 3 samples. The prevalence rates of U. urealyticum by PCR in 4 groups were 40.0%, 44.7%, 22.7% and 46.9% respectively, and there was no significant difference between G1～G2, G1～G4 or G2～G4 with a p value of 0.419, 0.325, 0.868 respectively, but the prevalence rate of U. urealyticum in G3 was significantly lower than that in other groups. Conclusions M. genitalium is strongly associated with NGU and the prevalence rate is significantly higher in groups with high risk sexual behaviors than that in general population. There is no association between the colonization of U. urealyticum and NGU.
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ObjectiveTodetectM.genitalium(Mg),M.penetrans(Mpe),M.pirum(Mpi),M.fermentans(Mf),Ureaplasmaurealyticum(Uu)andM.hominis(Mh)infectionsinurethra/cervicalcanalandpharynxandexploretheirclinicalsignificance.MethodsCultureandPCRwereperformedin72patientswithNGU/MPCtodetectMg,Mpe,Mpi,Mf,UuandMh.Thesecretionsfromurethra/cervicalcanalandpharynxweretested.ResultsMg,Mpe,Mpi,Mf,UuandMhweredetectedfromgenitalspecimensin23.6%,12.5%,2.8%,0,26.4%and8.5%ofpatients,respectively.Mg,Mpe,Mpi,Mf,UuandMhweredetectedfrompha-ryngealspecimensin24.6%,14.5%,0,0,2.9%and2.9%ofpatients,respectively.Thesamespeciesofmy-coplasmaswerefoundinbothgenitalandpharyngealspecimensin10patients(14.5%).ConclusionsUuandMginfectionsarecommoninpatientswithNGU/MPC.ThenewmycoplasmaspeciesMpeshouldbepaidattentionto.TheresultsindicatethatMgandMpemaybetransmittedbygenital-genitalsexandoral-genitalsex.MfmaybeofnoassociationwithNGU.