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Objective:To investigate the incidence and clinical characteristics of brucellosis in Yantai City of Shandong Province, and to provide reference for formulating prevention and control strategies of brucellosis.Methods:From January 2017 to December 2019, brucellosis cases reported by the Infectious Disease Reporting Information Management System of China Disease Prevention and Control Information System in Yantai City were analyzed, and their risk factors and clinical characteristics were analyzed.Results:A total of 225 cases of brucellosis were reported in Yantai City from 2017 to 2019, including 138 males and 87 females, with a gender ratio of 1.59 ∶ 1.00; the age was (43.25 ± 8.61) years, and the most common age was 30 - < 40 years (80 cases); in the regional distribution, Zhifu District was the most (96 cases); the onset time was mainly from January to May (147 cases). Among the risk factors of brucellosis cases, 196 cases (87.11%, 196/225) had close contact with animals or their products. The main clinical characteristics of brucellosis cases were fever (203 cases), fatigue (188 cases), arthralgia (184 cases) and hyperhidrosis (148 cases). All 225 cases of brucellosis were diagnosed in laboratory, including 56 cases (24.89%) with titer 1 ∶ 100 of serum tube agglutination test; 75 cases (33.33%) with titer 1 ∶ 200; and 94 cases (41.78%) with titer 1 ∶ 400. With the increase of titer level, the incidence of fever, hyperhidrosis, arthralgia and fatigue increased, and the differences were statistically significant ( P < 0.05). Conclusions:The incidence of brucellosis in Yantai City is mainly young and middle-aged males, which is common in people who have contact history with animals or their products, and the clinical manifestations are lack of specificity. Health education should be carried out among high-risk groups to improve their self-protection awareness, and brucellosis surveillance should be strengthened to reduce the incidence of brucellosis.
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Objective To investigate the value of intrathoracic contrast-enhanced ultrasound in the treatment of pleural effusion. Methods Forty-four patients in our hospital were selected; they had stopped drainage during closed thoracic drainage and had residual pleural effusion determined by pathogenetic condition. The resistance in the catheter during normal saline flushing, whether the effusion could be drained and the effusion traits, and the enhancement of catheter, chest wall soft tissue and pleural cavity after contrast-enhanced ultrasound were all observed. Clinical and ultrasound examination was used to judge whether the catheters were out of the effusion cavity and the accuracies of the two examination methods were compared. Results When the catheter was located in the effusion cavity, contrast-enhanced ultrasound showed a linear enhancement in the catheter and a slow enhancement in the effusion cavity; when the catheter was removed, contrast-enhanced ultrasound showed a short linear enhancement in the catheter, a limited area of enhancement in the chest wall soft tissue and no enhancement in the effusion cavity. In clinical judgment, 8 catheters were located in the effusion cavity, and 36 cases were removed. In ultrasound judgment, 29 catheters were located in the effusion cavity, 14 cases were removed, and 1 case could not be judged. Taking whether there is still liquid extraction 24 h after saline flushing or drug injection as the standard of catheter removing, we found that the accuracy of contrast-enhanced ultrasound in determining catheter removing was significantly higher than that of the clinical judgment (97.73% [43/44] vs 50.00% [22/44], P0.01). Conclusion Intrathoracic contrast-enhanced ultrasound can accurately judge the position of catheters and the internal condition of the effusion cavity. It provides a basis for further treatment of pleural effusion.
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Objective To analyze and compare the ultrasound elastography (UE) features of various types of cervical tuberculous lymphadenopathy (CTL), and to investigate the value and limitation of UE in diagnosis of CTL. Methods A total of 70 CTL patients confirmed by pathology or diagnostic treatment who were admitted to Shanghai Pulmonary Hospital affiliated to Tongji University from Jul. 2017 to Mar. 2018 were enrolled, and the images of conventional ultrasound and UE of the largest lymph nodes in each patient were retrospectively analyzed. According to the conventional ultrasound classification criteria of tuberculous lymphadenopathy, the lesions were divided into acute inflammatory type (type), caseous necrotic type (typeⅡ), cold abscess type (type III) and healing calcification type (type ). The elasticity score and strain ratio of various types of CTL lesions were summarized and compared. Results There were 24 (34.29%) typeCTL lesions, 28 (40.00%) typeⅡ, 12 (17.14%) type III, and 6 (8.57%) type . The hardness of CTL lesions of typeand typeⅡ was high, with the elastic score being 3-4 (47/52, 90.38%) and the strain ratio being 3-5; the hardness of type III was the lowest, with the elastic score being 1-2 (10/12, 83.33%) and the strain ratio2; the hardness of type was the highest, with the elastic score being 4-5 (6/6, 100.00%) and the strain ratio5. There were significant differences in elastic score and strain ratio among the four type CTL lesions (H＝30.756, F＝23.177; both P0.001). Pairwise comparison showed that except for the differences between typeand typeⅡ lesions, there were significant differences in elastic scores and strain ratios between the four type CTL lesions (P0.05). Conclusion The value of UE in the diagnosis of CTL is limited. It may play some roles in determining whether there is an obvious granuloma formation in typelesions and the tension of type III lesions.
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Objective To formulate standardized program of gastric lavage for acute organophosphorus pesticide poisoning(AOPP) and evaluate the effects.Methods Evidence was obtained via evidence-based approach,and recommendations were formed.The standardized program of gastric lavage for AOPP was formulated and then applied to clinical practice.The effects were evaluated by examining indicators of success rate of catheterization,the first time of gastric lavage,the time of atropinization and total usage of atropine,ChE recovery time,hospital stay,rebound rate,adverse event rate.Results After implementation,the first time of gastric lavage,the time of atropinization,total usage of atropine,ChE recovery time,and hospital stay were significantly lower than the control group (P＜0.05).Conclusion Evidence-based practice of gastric lavage for AOPP can improve therapeutic effects,reduce adverse reactions,improve quality of nursing,and promote safety of medical care.
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The applications are narrow in the scope of conventional ultrasound-guided lung biopsy due to the restriction of techniques.With the development and application of new ultrasonic techniques,a number of novel ultrasound-guided methods are applied in lung biopsy,which not only improv the accuracy of diagnosis,but also extend to special locations where conventional methods are difficult to obtain samples.The application of new ultrasonic technology in lung biopsy were reviewed in this article.
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The applications are narrow in the scope of conventional ultrasound-guided lung biopsy due to the restriction of techniques.With the development and application of new ultrasonic techniques,a number of novel ultrasound-guided methods are applied in lung biopsy,which not only improv the accuracy of diagnosis,but also extend to special locations where conventional methods are difficult to obtain samples.The application of new ultrasonic technology in lung biopsy were reviewed in this article.
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Objective To investigate the application effect of scene exercise training model of 6 emergency disease entities in the junior nurses training .Methods Thirty‐six newly employed nurses during 2010-2013 were performed the scene exercise train‐ing of six disease entities .Before and after training ,the the forms of questionnaire investigation ,written examination and implemen‐tation were adopted to survey and analyze the post competence ,training attitude ,theoretical knowledge ,operation skill ,single time for help and participating doctor′s satisfaction on the coordinate ability .Results After training ,the aspects of post competence , training attitude ,theoretical knowledge ,operation skills ,single time for help and participating doctor′s satisfaction on the coordinate ability in junior nurse were significantly improved ,the differences between before and after training had statistical significance (P<0 .01 or P<0 .05) .Conclusion Using the scene exercise training model of 6 emergency disease entities in junior nurses training has active significance for increasing the overall quality of junior nurses .