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Objective:To clarify the clinical characteristics and related fators of children with delayed antibody production of mycoplasma pneumoniae pneumonia(MPP).Methods:Two hundreds and eithty-five cases of children hospitalized at Children′s Hospital of Soochow University with MPP(positive for nucleic acid testing of respiratory secretion)were chosen from January 1st, 2019 to September 31st, 2019.Delayed antibody production group included 36 cases, who were tested for negative IgM antibody meanwhile the titer of IgG antibody changed less than 4 folds within 14 days.Positive group included 249 cases who were tested for positive IgM antibody or the titer of IgG antibody changed over 4 folds within 14 days.The characteristics of clinical manifestation, immunology and radiology were comparatively analyzed.Results:The medium age of delayed antibody production group was 0.75(0.30, 2.78)years old, which was obviously younger than that from positive group[5.50(3.73, 7.20)years old]( P<0.001). Low level of serum immunoglobulin IgG was the independent effect factor of delayed production for Mycoplasma pneumoniae antibody( P=0.037). When the serum immunoglobulin IgG level was lower than 7.155mmol/L, the sensitivity of predicting delayed production for mycoplasma pneumoniae antibody would be 0.819 and the specificity was 0.833.The underlying diseases associated with delayed antibody production were hospitalization history during neonatal period( P=0.007)and congenital heart disease( P=0.001). There were 11.11%(4/36)of children appearing spasmodic cough, 41.67%(15/36)of children showing wheezing and 33.33%(12/36)showing diarrhea in delayed antibody group, which were significantly higher than those in positive group[0.40%(1/249), 24.50%(61/249)and 9.64%(24/249), respectively, P<0.05]. The incidence of fever in delayed antibody group were 63.89%(23/36), which was lower than that in positive group[92.37%(230/249)]( P<0.001), meanwhile, the fever last time was 2.50(0, 4.75)days in delayed antibody group, which was shorter than that in positive group[ 7(5.00, 8.50)days]( P<0.001). In the delayed antibody group, there was 19.44%(7/36)of children sufferring from lobar pneumonia, and no extrapulmonary manifestations occurred, which were significantly lower than those in positive group[75.50%(188/249), 14.86%(37/249)]( P<0.05). Conclusion:Delayed antibody production in children with MPP is more common when serum immunoglobulin IgG level is lower than 7.155 mmol/L, especially in the presence of neonatal hospital history and congenital heart disease.The clinical manifestations of these children are mainly characterized by spasmodic cough and wheezing, with low probability of fever, lobular pneumonia and extrapulmonary manifestations.
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@#Objective To investigate the value of chest high-resolution computed tomography (HRCT) score in evaluating the severity of hip fracture-induced early acute lung injury (ALI) in the elderly patients. Methods The clinical data of 289 elderly hip fracture patients in Chongqing Traditional Chinese Medicine Hospital from July 2014 to April 2020 were retrospectively analyzed. All patients were divided into two groups, including an ALI group (n=114, 36 males and 78 females at age of 82.94±6.85 years) and a non-ALI group (n=175, 51 males and 124 females at age of 84.42±6.31 years). General information, chest HRCT scores and PaO2/FiO2 were compared between the two groups. Correlation analysis was used to compare the relationship between chest HRCT scores and PaO2/FiO2. Multiple linear stepwise regression analysis was applied to evaluate the effective extent of the diffuse ground glass opacity (DGGO), intense parenchymal opacification (IPO), and reticulation HRCT scores to the overall HRCT scores. Results The DGGO scores, IPO scores, reticulation scores, overall HRCT scores and PaO2/FiO2 were higher in the ALI group than those in the non-ALI group (P<0.001). In the ALI group, correlation analysis showed that DGGO, overall HRCT scores were in significantly negative correlation with PaO2/FiO2 (P<0.001). In addition, the correlation among PaO2/FiO2 and overall HRCT scores was more significant than that of DGGO scores. Multiple stepwise regression analysis indicated that DGGO, IPO, and reticulation scores were independent influencing factors for overall HRCT scores. Among the influencing factors, DGGO scores had the greatest impact, then IPO scores and reticulation scores. The HRCT signs of DGGO, IPO, and reticulation appeared simultaneously had the greatest effects on the overall HRCT scores. Conclusion The chest HRCT score, which is associated with PaO2/FiO2, also can be used in the severity assessment of elderly patients with early ALI caused by hip fracture.
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Currently, the outbreak of the new coronary pneumonia has entered a critical period of screening, prevention and control.In order to block the transmission of the virus in the radiology department, it is particularly important to effectively protect the medical servant while speeding up the flow of inspection.Based on the basis of notification of the bureau of disease control and prevention, the expert consensus of the CMA and CMDA, and the literature review, combined with the previous practical work experience,this article puts forward the recommendations on the important effect of nursing-technology integrated in the imaging examination of novel coronavirus pneumonia, in order to provide reference for the protection of medical servant in the radiology department at the front line of anti-epidemic.
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Objective@#To research build a kind of occupational disease risk assessment model which provides scientific basis for prevention and control of occupational diseases.@*Methods@#Based on the principle of information diffusion, this paper uses spread function to extend the incomplete gathered information, establishes the mapping relationship between observation samples and risk probability distributions, and constructs the occupational disease risk assessment model, to analyzes the risk data of occupational disease reported cases in Guangdong Province in the past five years.@*Results@#Through evaluation analysis, every year, 200-300 cases of pneumoconiosis probability is 67.77%, 100-200 cases of occupational poisoning probability is 68.52%, 20-40 cases of occupational cancers probability is 71.62%, each year, the incidence of occupation otorhinolaryngology and oral diseases in 200 cases was 62.23%.@*Conclusion@#A model of occupational disease risk assessment based on information diffusion theory is constructed, the evaluation result is basically consistent with the actual situation of occupational disease, which can provide reference for occupational disease prevention and control.
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Objective@#To understand the epidemiological characteristics of influenza A(H1N1)pdm09 virus in Sichuan population during the monitoring period of 2018-2019, and to clarify the antigenic variation, the gene characteristics and the matching of current epidemic strains, vaccine strains, representative strains at home and abroad.@*Methods@#A total of 118 strains of influenza A(H1N1)pdm09 virus isolated in Sichuan region influenza network laboratory from April 2018 to March 2019 were selected. The hemagglutination inhibition (HI) assay was conducted for antigen analysis. The HA and NA genes of 16 strains with low-response strains were sequenced. Phylogenetic analysis and amino acid locus variation analysis were applied using BioEdit and MEGA5.0 software.@*Results@#The result of the antigen analysis demonstrated that more than 95% of the A(H1N1) pdm09 influenza viruses detected were similar to the WHO recommended vaccine strain A/Michigan/45/2015. The analysis of HA gene characteristics showed that some low-response strains had amino acid site variation in the Sa, Sb and Cb regions of the HA protein. A total of 15 low-response strains belonged to the 6B.1 branch. And their evolutionary relationship were close to the representative strains A/beijin-xicheng/SWL1633/2018 and A/brisbane/02/2018, which were popular at home and abroad. Compared with A/sichuan/1/2009, there are mutations involving 6, 14 and 1 amino acid sites in the antigen-determining regions (Sa, Sb, Ca and Cb), non-determined regions and receptor binding site(RBS) respectively. No amino acid site mutations related to resistance to NA gene were found.@*Conclusions@#In 2018-2019, the epidemic A(H1N1) pdm09 influenza virus in Sichuan is consistent with the global epidemic characteristics, which also matched with vaccine strains recommended by WHO in the northern hemisphere. Compared with A/sichuan/1/2009 which was the first isolated in China in 2009, there were amino acid sites mutations in antigen-determining region and receptor binding site of the HA protein, and the transmembrane region of the NA protein, drug and antibody binding sites.
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Objective@#To investigate the application value of magnetic resonance imaging (MRI) in the classification diagnosis of rectal mucinous adenocarcinoma.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 74 patients with rectal mucinous adenocarcinoma who were admitted to Chongqing Traditional Chinese Medicine Hospital from July 2009 and February 2019 were collected. There were 40 males and 34 females, aged (46±8)years, with a range from 32 to 82 years. Among the 74 patients, 41 were simple mucinous adenocarcinoma, 26 were partial mucinous adenocarcinoma, and 7 were focal or small foci mucinous adenocarcinoma. All patients underwent MRI plain scan and dynamic enhanced scan. Observation indicators: (1) morphology of rectal mucinous adenocarcinoma; (2) the lesion margin of rectal mucinous adenocarcinoma; (3) the value of apparent diffusion coefficient (ADC) of rectal mucinous adenocarcinoma; (4) internal enhancement features of rectal mucinous adenocarcinoma; (5) timesignal intensity curve of rectal mucinous adenocarcinoma. Measurement data with normal distribution were represented as Mean±SD, and count data were described as absolute numbers.@*Results@#(1) Morphology of rectal mucinous adenocarcinoma: 74 patients had different morphological changes. Among the 41 cases of simple mucinous adenocarcinoma, 22 were oval, 8 were round, and 11 were irregular. Among the 26 patients with partial mucinous adenocarcinoma, 15 were oval, 8 were round and 3 were irregular. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 2 were oval, 1 was round and 4 were irregular. (2) The lesion margin of rectal mucinous adenocarcinoma: the lesion margin of 74 patients was mainly unclear and irregular. Among the 41 cases of simple mucinous adenocarcinoma, 32 had unclear and irregular margin, 7 had clear margin, and 2 had unclear margin combined with fissure. Among the 26 cases of partial mucinous adenocarcinoma, 20 had unclear margin combined with fissure, 5 had unclear margin and irregular margin, and 1 had clear margin. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 5 had unclear or irregular margin, 1 had unclear or irregular margin, and 1 had clear margin. (3) The value of ADC of rectal mucinous adenocarcinoma: diffusion weighted imaging of 74 patients showed diffused limited changes. The average ADC value was (1.24±0.23)×10-3 mm2/s of 41 patients with simple mucinous adenocarcinoma, (0.91±0.42)×10-3 mm2/s of 26 patients with partial mucinous adenocarcinoma, and (1.07±0.24)×10-3 mm2/s of 7 patients with focal or small mucinous adenocarcinoma. (4) Internal enhancement features of rectal mucinous adenocarcinoma: 74 patients showed delayed heterogeneous enhancement and marginal enhancement. Among 41 cases of simple mucinous adenocarcinoma, 24 showed delayed heterogeneous enhancement, 17 showed marginal enhancement, and none showed homogeneous enhancement. Among 26 patients with partial mucinous adenocarcinoma, 20 showed marginal enhancement, 6 showed homogeneous enhancement, and none showed heterogeneous enhancement. All the 7 cases of focal or small foci mucinous adenocarcinoma showed heterogeneous enhancement. (5) Timesignal intensity curve of rectal mucinous adenocarcinoma: 74 patients showed mainly outflow type in the timesignal intensity curve. Among the 41 cases of simple mucinous adenocarcinoma, 22 presented progressive curve, 12 presented platform type, and 7 presented outflow type. Among the 26 patients with partial mucinous adenocarcinoma, 17 presented outflow type, 8 presented platform type, and 1 presented progressive type. Among the 7 patients with focal and small forci mucinous adenocarcinoma, 4 presented outflow type, 2 presented platform type, and 1 presented progressive type.@*Conclusions@#MRI findings show different results for different types of rectal mucinous adenocarcinoma. A correct understanding of the MRI features of different types of rectal mucinous adenocarcinoma is helpful for the classification diagnosis of rectal mucinous adenocarcinoma.
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Objective To investigate the application value of magnetic resonance imaging (MRI) in the classification diagnosis of rectal mucinous adenocarcinoma.Methods The retrospective and descriptive study was conducted.The clinical data of 74 patients with rectal mucinous adenocarcinoma who were admitted to Chongqing Traditional Chinese Medicine Hospital from July 2009 and February 2019 were collected.There were 40 males and 34 females,aged (46± 8)years,with a range from 32 to 82 years.Among the 74 patients,41 were simple mucinous adenocarcinoma,26 were partial mucinous adenocarcinoma,and 7 were focal or small foci mucinous adenocarcinoma.All patients underwent MRI plain scan and dynamic enhanced scan.Observation indicators:(1) morphology of rectal mucinous adenocarcinoma;(2) the lesion margin of rectal mucinous adenocarcinoma;(3)the value of apparent diffusion coefficient (ADC) of rectal mucinous adenocarcinoma;(4) internal enhancement features of rectal mucinous adenocarcinoma;(5) timesignal intensity curve of rectal mucinous adenocarcinoma.Measurement data with normal distribution were represented as Mean ±SD,and count data were described as absolute numbers.Results (1) Morphology of rectal mucinous adenocarcinoma:74 patients had different morphological changes.Among the 41 cases of simple mucinous adenocarcinoma,22 were oval,8 were round,and 11 were irregular.Among the 26 patients with partial mucinous adenocarcinoma,15 were oval,8 were round and 3 were irregular.Among the 7 patients with focal or small foci mucinous adenocarcinoma,2 were oval,1 was round and 4 were irregular.(2) The lesion margin of rectal mucinous adenocarcinoma:the lesion margin of 74 patients was mainly unclear and irregular.Among the 41 cases of simple mucinous adenocarcinoma,32 had unclear and irregular margin,7 had clear margin,and 2 had unclear margin combined with fissure.Among the 26 cases of partial mucinous adenocarcinoma,20 had unclear margin combined with fissure,5 had unclear margin and irregular margin,and 1 had clear margin.Among the 7 patients with focal or small foci mucinous adenocarcinoma,5 had unclear or irregular margin,1 had unclear or irregular margin,and 1 had clear margin.(3) The value of ADC of rectal mucinous adenocarcinoma:diffusion weighted imaging of 74 patients showed diffused limited changes.The average ADC value was (1.24 ± 0.23) × 10-3 mm2/s of 41 patients with simple mucinous adenocarcinoma,(0.91±0.42)× 10-3 mm2/s of 26 patients with partial mucinous adenocarcinoma,and (1.07±0.24)× 10-3 mm2/s of 7 patients with focal or small mucinous adenocarcinoma.(4) Internal enhancement features of rectal mucinous adenocarcinoma:74 patients showed delayed heterogeneous enhancement and marginal enhancement.Among 41 cases of simple mucinous adenocarcinoma,24 showed delayed heterogeneous enhancement,17 showed marginal enhancement,and none showed homogeneous enhancement.Among 26 patients with partial mucinous adenocarcinoma,20 showed marginal enhancement,6 showed homogeneous enhancement,and none showed heterogeneous enhancement.All the 7 cases of focal or small foci mucinous adenocarcinoma showed heterogeneous enhancement.(5) Timesignal intensity curve of rectal mucinous adenocarcinoma:74patients showed mainly outflow type in the timesignal intensity curve.Among the 41 cases of simple mucinous adenocarcinoma,22 presented progressive curve,12 presented platform type,and 7 presented outflow type.Among the 26 patients with partial mucinous adenocarcinoma,17 presented outflow type,8 presented platform type,and 1 presented progressive type.Among the 7 patients with focal and small forci mucinous adenocarcinoma,4 presented outflow type,2 presented platform type,and 1 presented progressive type.Conclusions MRI findings show different results for different types of rectal mucinous adenocarcinoma.A correct understanding of the MRI features of different types of rectal mucinous adenocarcinoma is helpful for the classification diagnosis of rectal mucinous adenocarcinoma.
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Objective The various influencing factors in the process of nano-silver preparation were studied in order to prepare nano-silver that has uniformity particle size distribution and good crystallinity. Methods Through the method of liquid reduction at room temperature,the nano-silver powders were prepared directly using silver nitrate as raw material,water as the reactive medium,polyvinylpyrrolidone(PVP) as protecting agent and ammonium formate as reducing agent. By means of EDS and TEM(transmission electron microscopy),the prepared silver particles were characterized. The various influencing factors in the process of preparation were also discussed. Results With the increasing concentration of AgNO3,the particle diameter of nano-silver changed obviously. When the concentration of silver nitrate was 0.25-0.30 mol/L,the size of product is the smallest. With the increasing concentration of reductant,the diameter of nano-silver decreased gradually. While at the concentration of 0.70 mol/L HCOOH,the average diameter of nano-silver is not more than 10 nm. Smaller and more well-distributed silver powder could be prepared at ratio of concentration of PVP to AgNO3 with the value of 1.5-1.0,at which PVP presented effective protection. Conclusions This method can prepare particle of nano-silver which revealed well dispersed and uniform size. The process is stable and reliable,easy to operate,high yields and suitable for industrial production.