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BACKGROUND@#Cholecystectomy is a standard surgery for patients suffering from gallbladder diseases, while the causal effects of cholecystectomy on colorectal cancer (CRC) and other complications are still unknown.@*METHODS@#We obtained genetic variants associated with cholecystectomy at a genome-wide significant level ( P value <5 × 10 -8 ) as instrumental variables (IVs) and performed Mendelian randomization (MR) to identify the complications of cholecystectomy. Furthermore, the cholelithiasis was also treated as the exposure to compare its causal effects to those of cholecystectomy, and multivariable MR analysis was carried out to judge whether the effect of cholecystectomy was independent of cholelithiasis. The study was reported based on Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization guidelines.@*RESULTS@#The selected IVs explained 1.76% variance of cholecystectomy. Our MR analysis suggested that cholecystectomy cannot elevate the risk of CRC (odds ratio [OR] =1.543, 95% confidence interval [CI]: 0.607-3.924). Also, it was not significant in either colon or rectum cancer. Intriguingly, cholecystectomy might decrease the risk of Crohn's disease (OR = 0.078, 95% CI: 0.016-0.368) and coronary heart disease (OR = 0.352, 95% CI: 0.164-0.756). However, it might increase the risk of irritable bowel syndrome (IBS) (OR = 7.573, 95% CI: 1.096-52.318). Cholelithiasis could increase the risk of CRC in the largest population (OR = 1.041, 95% CI: 1.010-1.073). The multivariable MR analysis suggested that genetic liability to cholelithiasis could increase the risk of CRC in the largest population (OR = 1.061, 95% CI: 1.002-1.125) after adjustment of cholecystectomy.@*CONCLUSIONS@#The study indicated that cholecystectomy might not increase the risk of CRC, but such a conclusion needs further proving by clinical equivalence. Additionally, it might increase the risk of IBS, which should be paid attention to in clinical practice.
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Humans , Mendelian Randomization Analysis , Irritable Bowel Syndrome , Colorectal Neoplasms/genetics , Cholelithiasis/complications , Cholecystectomy/adverse effects , Genome-Wide Association Study , Polymorphism, Single NucleotideABSTRACT
This article aims to provide a review of the domestic and foreign studies on the quality indicators for evaluating the psychiatric nursing care in recent years. According to Donabedian model， the research progress of quality indicators for evaluating the psychiatric nursing care were described from the three dimensions of structure quality， process quality and outcome quality. This paper summarizes the status of the research， points out the shortcomings of existing research， and provides references for the future research on the quality indicators for evaluating the psychiatric nursing care.
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ObjectiveTo investigate the current status of knowledge， attitude and practice of nurses in mental health hospitals on the prevention and control of nosocomial infections， and to analyze the influencing factors. MethodsFrom June to August 2020， 402 clinical nurses from 8 mental health hospitals in a city were enrolled using simple random sampling method， and were assessed using a self-compiled knowledge-attitude-practice questionnaire related to the nosocomial infection prevention and control， thereafter， the influencing factors were screened. ResultsThe scores of knowledge， attitude and practice dimensions in relation to the nosocomial infection prevention and control among the nurses were （8.43±1.84）， （76.01±5.70） and （57.42±3.75）， respectively. Univariate analysis showed that the knowledge dimension score demonstrated significant difference among nurses of different types of hospital， grades of hospital， professional titles， education levels， and emphasis degrees of hospital and individual on nosocomial infection （P<0.05 or 0.01）. The attitude dimension scores yielded significant difference among nurses of different types of hospital， position， grades of hospital， and emphasis degrees of hospital and individual on nosocomial infection （P<0.05 or 0.01）. The practice dimension scores manifested significant difference among nurses of different types of hospital， grades of hospital， professional titles， emphasis degrees of hospital and individual on nosocomial infection， and training frequency （P<0.05 or 0.01）. Multiple linear regression analysis showed that professional titles and individual emphasis on nosocomial infection entered the regression model of nurses' knowledge dimension of nosocomial infection prevention and control （P<0.05 or 0.01）. Individual emphasis on nosocomial infection， hospital types and position entered the regression model of attitude dimension （P<0.05 or 0.01）. Individual emphasis on nosocomial infection， hospital types， professional titles， and hospital emphasis on nosocomial infection entered the regression model of practice dimension （P<0.05 or 0.01）. ConclusionNurses in mental health hospital have a positive attitude towards nosocomial infection prevention and control， but their knowledge base needs to be strengthened.
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【Objective】 To investigate the serological and molecular biological characteristics of para-Bombay phenotype. 【Methods】 ABO blood type, H antigen and Lewis blood type in one blood sample with discrepancy between forward and reverse blood typing were detected by serological method. Antibody screening and identification and cross-match test were also performed by serological method. ABO blood group genes were detected by PCR-SSP, and FUT1 and FUT2 genes were sequenced. 【Results】 The serological test showed that the Para-Bombay phenotype was Ah secretion. The ABO blood group gene was AO2. FUT1 sequencing revealed two mutations: 235G>C and 881_882delTT. While FUT2 sequencing showed only one mutation 357C>T. 【Conclusion】 The discovery and accurate identification of blood groups is necessary to ensure the safety of blood transfusion. Blood donors of rare blood groups should be informed and recruited to the team of rare blood donors.
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Objective:To investigate the value of D-dimer, carbohydrate antigen 199 (CA199) and insulin-like growth factor binding protein 2 (IGFBP2) for postoperative monitoring and prediction of survival time in patients with resectable pancreatic cancer.Methods:The data of 119 patients with pancreatic cancer who were admitted to the First Hospital of Qinhuangdao from May 2010 to January 2014 were collected. Immunoturbidimetry was used to determine the level of D-dimer before surgery, at postoperative stable disease stage and disease progression stage; electrochemiluminescence was used to determine the level of CA199, and enzyme-linked immunosorbent assay (ELISA) was used to determine the serum IGFBP2 level. A total of 30 healthy people and 40 patients with pancreatic serous cystadenoma were treated as the controls. The correlations of the levels of preoperative D-dimer, CA199 and IGFBP2 with clinicopathological characteristics and survival time of patients with pancreatic cancer were analyzed.Results:The levels of preoperative D-dimer, CA199, IGFBP2 in patients with pancreatic cancer were higher than those in the both control group (all P < 0.01). The levels of serum D-dimer, CA199 and IGFBP2 after the progression of pancreatic cancer were higher than those at postoperative stable disease stage [1 496.0 ng/ml (590.0 ng/ml, 2 280.4 ng/ml) vs. 578.1 ng/ml (381.7 ng/ml, 671.5 ng/ml), 207.0 U/ml (54.5 U/ml, 736.5 U/ml) vs. 31.9 U/ml (14.1 U/ml, 44.0 U/ml), (435±107) ng/ml vs. (249±83) ng/ml, all P < 0.01]. There were no statistical differences in the proportion of pancreatic cancer patients stratified by different clinicopathological factors with the increased levels of D-dimer before operation (all P > 0.05). The proportion of the increased levels of CA199 and IGFBP2 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis (both P < 0.05); there was no association of the increased levels of CA199 and IGFBP2 with other factors (all P > 0.05). The preoperative progression-free survival (PFS) time and overall survival (OS) time of pancreatic cancer patients with elevated D-dimer level was shorter than that for those with normal D-dimer level [(10.6±1.2) months vs. (20.4±2.4) months, (18.9±1.9) months vs. (29.2±2.6) months, both P < 0.01]. When the threshold value of CA199 was 37 U/ml, there was no correlation between CA199 and survival of pancreatic cancer patients (all P > 0.05); when the threshold value was 253.8 U/ml (median CA199 for the enrolled patients) and 1 000 U/ml, patients with elevated CA199 level had shorter OS time and PFS time compared with the patients with normal CA199 level [253.8 U/ml: (11.5±1.5) months vs. (21.0±2.6) months, (19.9±2.1) months vs. (29.0±2.7) months, both P < 0.01; 1 000 U/ml: (8.9±1.9) months vs. (19.1±1.9) months, (15.5±2.3) months vs. (28.0±2.0) months, both P < 0.01]. When the threshold value of IGFBP2 was 339.1 ng/ml, patients with elevated preoperative IGFBP2 level had shorter PFS time and OS time compared with the patients with normal IGFBP2 level [(10.8± 1.1) months vs. (21.1±2.6) months, (18.9±1.8) months vs. (30.3±2.8) months, both P < 0.01]. Cox multivariate analysis showed that preoperative D-dimer and IGFBP2 levels were independent factors affecting PFS and OS in patients with pancreatic cancer (D-dimer: HR = 0.561, 95% CI 0.336-0.936, P = 0.027; HR = 0.515, 95% CI 0.303-0.874, P = 0.014; IGFBP2: HR = 0.430, 95% CI 0.253-0.731, P = 0.002; HR = 0.361, 95% CI 0.202-0.644, P = 0.001). Conclusions:For patients with resectable pancreatic cancer, D-dimer, CA199 and IGFBP2 can be used for postoperative condition monitoring, and preoperative D-dimer and IGFBP2 can be used for survival time prediction.
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Patent ducts arteriosus is a type of common congenital disease.Currently,there are a variety of clinical treatments,including drug treatment,surgical treatment and interventional treatment.In recent years,with the rapid development of interventional technology and related materials,interventional therapy has gradually become the preferred treatment option for PDA.This review summarizes the therapeutic indications,the measuring methods of PDA,the choice of devices and postoperative complications,cardiac structure and function change in pediatric patients.
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Objective To explore the efficacy and safety of apatinib combined with S-1 in patients with advanced NSCLC without sensitive gene mutation or unknown mutation status.Methods One hundred and four patients with advanced NSCLC without sensitive gene mutation or unknown mutation status were selected from the oncology department of the First Hospital of Qinhuangdao City,Hebei Province from April 2015 to April 2017.All patients refused intravenous chemotherapy.One hundred and four patients were randomly divided into treatment group (apatinib combined with S-1 group) and control group (S-1 alone group) by 1:1 digital method.However,two patients in the treatment group transferred to the control group for personal reasons.There is 50 cases in apatinib combined with S-1 group and 54 cases in S-1 group.The efficacy and adverse reactions of the two groups were evaluated.Results The objective remission rate was 48.0％ (24/50) and 27.8％ (15/54) (x2=4.530,P =0.033),the disease control rate was 82.0％ (41/50) and 74.1％ (40/54) (x2=0.947,P=0.331),the median PFS was 6.6 months and 3.4 months (t=25.555,P =0.000),the median OS was 16.0 months and 10.5 months (t =59.439,P =0.000),respectively.The overall incidence of adverse reactions was 82.0％ (41/50) and 70.4％ (38/54) respectively (x2 =1.923,P=0.166),of which 18.0％ (9/50) and 13.0％ (7/54) were more than grade 3 respectively (x2 =0.506,P =0.477).There was no death caused by treatment-related adverse reactions in both groups.Conclusion Appatinib combined with S-1 capsule has good short-term and long-term efficacy in the treatment of advanced non-small cell lung cancer without gene mutation or unknown mutation.The adverse reactions are tolerable and can be used as first-line treatment for patients unwilling to receive intravenous chemotherapy.
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Objective To study the risk factors for progressive cardiogenic stroke (CS).Methods Seventy-one acute ischemic stroke patients admitted to our hospital from 2008-08-01 to 2014-12-31 were divided into progressive CS group (n=14) and non-progressive CS group (n=57).The NIHSS was used to assess the neurologic deficit when the patients were admitted and 30 days after the stroke onset.Their clinical data were retrospectively analyzed.The risk factors for progressive CS were analyzed by univariate logistic regression analysis and multivariate logistic regression analysis respectively,their critical thresholds were analyzed according to the ROC curve.Results The NIHSS improvent of the progressive CS group was significantly less than that of the non-progressive CS group (P＜0.01).The age was significantly older,the incidence of right-side infarction and the serum level of D-dimer were significantly higher while the serum level of glutamic pyruvic transaminase was significantly lower in progressive CS group than in non-progressive CS group (77.29±8.87 years vs 71.44±9.51 years,P=0.041;71.4％ vs 33.3％,P=0.009;2.82 mg/L vs 0.91 mg/L,P=0.048;13.79±4.44 U/L vs 21.98±17.34 U/L,P=0.002).Lo gistic regression analysis showed a significant difference in age,right-side infarction and serum D-dimer level between the two groups (P=0.030,P=0.007,P=0.025).The area under the ROC curve revealed that age ＞ 70.75 years and serum D-dimer level ＞1.23 mg/L were the risk factors for progressive CS.Conclusion Age,right-side infarction and serum D-dimer level are the risk factors for progressive CS and can thus be used as predictors of progressive CS.
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In order to understand the patients' physique accurately,and formulate individualized conditioning scheme for patients with biased physique,our hospital established a new clinic called physique nursing clinic of Traditional Chinese Medicine (TCM) in August 2017,formed a series of corresponding rules and management regulations,and made clear the focus of the clinic and the work content of outpatient nurses.After implementation,the physique nursing clinic of TCM has achieved various goals:a total of 526 cases of TCM physique identification were carried out,324 patients with biased physique were given health guidance,and 148 cases of referral treatment.Hospital organized clinic members to go out to study for 10 times,and the voluntary community clinic were developed for 4 times.The physique nursing clinic of TCM has been appreciated by outpatients,doctors and nurses,who believed it could meet patients' individualized health needs and promote the development of TCM nursing.
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Objective To verify the performance of LIAISON chemiluminescence immunoassay analyzer in the prenatal screening for TORCH .Methods Reference to the US Institute of Clinical and Laboratory Stand-ards(NCCLS) series of documents and literature and combining with actual work ,we designed the verification program ,and tested and evaluated the LIAISON chemiluminescent immunoassay systems for the measurement precision ,accuracy ,linearity analysis ,clinical reportable range and biological reference intervals of Tox IgG , Tox IgM ,Rub IgG ,Rub IgM ,CMV IgG ,CMV IgM ,HSV IgG ,HSV IgM .We also compared the results with analysis performance provided by manufacturers (Italy LIAISON ) or recognized quality indicators .Results Intra-assay imprecision CV values were between 3 .58％ -7 .03％ ,which were less than the predetermined range;inter-assay imprecision CV values were between 3 .13％ -10 .73％ .Linear range validation regression coefficients a values were between 0 .97 -1 .03 and r2 >0 .95 .The linear relationship met the requirements . Both biological reference interval and reportable range meet the requirements .Conclusion The performance of LIAISON chemiluminescence immunoassay detection system satisfied the clinical requirements ,and the meas-urement results had advantages of high sensitivity ,specificity ,stability ,wide detection range ,good accuracy and repeatability ,which was suitable for clinical application .
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Objective: To analyze the characteristics of the healthy state of TCM (Traditional Chinese Medicine) of female, and preliminarily constructs the model of TCM health status identification of female with menstrual cycle. Methods: The text of disease diagnosis and syndrome differentiation of menstrual-cycle-linked disorders from Guidelines for diagnosis and treatment of common disease of gynecology in Traditional Chinese Medicine was analyzed, and the symptoms related with viscera functions, the waxing and waning of qi and blood, and pathogenic properties were extracted. The questionnaires of diseases and syndrome elements differentiation of female by calculating the weight relationship between symptoms and health status were designed to estimate the interior state of waxing and waning of yin-yang by figuring out the different periods of menstrual, and in the last step, Constitution in Chinese medicine Questionnaire was used to identify the constitution. Through the above four identification methods, a comprehensive identification of the female's health status of TCM was formed. Results: Through the disease identification model, we distinguished the state of disease and yet disease. And through the syndrome elements differentiation model, we knew the viscera functions, the waxing and waning of qi-blood and yin-yang, and pathogenic properties. And by identifying the internal qi-blood and yin-yang status, we initially built the model that can identify health status of female integrally with the constitution. Conclusion:The model identification results can reflect the comprehensive health status of female in multiple dimensions. It can make a fine classification of women.s TCM health status. It can not only help to know the previous health status but also help to speculate the future health trend, which contributes to the formulation of personalized health interventions of follow-up.
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Hepatorenal syndrome (HRS) is one of the most serious complications of end-stage liver disease. Type Ⅰ/Ⅱ HRS has a high short-term mortality rate and poor prognosis. The diagnostic criteria for HRS based on serum creatinine cannot keep up with the world, and early diagnosis is of great importance to the treatment and prognosis of HRS. This article introduces the value and clinical significance of seven biomarkers for renal injury in the early diagnosis, differential diagnosis, and prognostic evaluation of HRS. It is pointed out that neutrophil gelatinase-associated lipocalin, interleukin-18, and kidney injury molecule-1 may be the biomarkers for early identification of renal injury in patients with liver cirrhosis. A combination of multiple biological indicators, imaging examination, and interventional techniques might be a feasible method for early diagnosis of HRS in future.
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Objective To observe the peripapillary choroidal thicknesses (pCT) and subfoveal choroidal thicknesses (SFCT) of nonarteritic anterior ischemic optic neuropathy (NAION). Methods Forty-four Chinese patients with unilateral NAION were recruited and compared with 60 eyes of 60 normal age and refractive-error matched control subjects. pCT and SFCT were measured by enhanced depth imaging optical coherence tomography. Choroidal thicknesses of eyes with NAION and unaffected fellow eyes were compared with normal controls. Choroidal thicknesses of NAION eyes with or without optic disc edema were also compared. The correlation between choroidal thickness and retinal nerve fiber layer (RNFL) thickness, logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), and the mean deviation (MD) of Humphrey static perimetry in NAION eyes were analyzed. Results The pCT at the nasal, nasal inferior and temporal inferior quadrants in NAION eyes with optic disc edema were significantly thicker than that of normal subjects (t=3.152, 3.166, 2.808; P<0.05). There was no significant difference in the choroidal thicknesses between the unaffected fellow eyes of NAION patients and normal eyes of healthy controls; or between the NAION eyes with resolved optic disc edema and normal eyes (P>0.05). No significant correlation between choroidal thickness (r=-0.220, -0.140, 0.110), SFCT (r=0.096, -0.148, -0.131) and logMAR BCVA, perimetry MD and RNFL was found in eyes affected by NAION (P>0.05). Conclusions The peripapillary choroidal thicknesses increase in some quadrants in NAION eyes with optic disc edema. However, the choroidal thickness of NAION eyes is the same in age and refractive error-matched normal subjects.
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Objective To observe the peripapillary choroidal thicknesses (pCT) and subfoveal choroidal thicknesses (SFCT) of nonarteritic anterior ischemic optic neuropathy (NAION). Methods Forty-four Chinese patients with unilateral NAION were recruited and compared with 60 eyes of 60 normal age and refractive-error matched control subjects. pCT and SFCT were measured by enhanced depth imaging optical coherence tomography. Choroidal thicknesses of eyes with NAION and unaffected fellow eyes were compared with normal controls. Choroidal thicknesses of NAION eyes with or without optic disc edema were also compared. The correlation between choroidal thickness and retinal nerve fiber layer (RNFL) thickness, logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), and the mean deviation (MD) of Humphrey static perimetry in NAION eyes were analyzed. Results The pCT at the nasal, nasal inferior and temporal inferior quadrants in NAION eyes with optic disc edema were significantly thicker than that of normal subjects (t=3.152, 3.166, 2.808; P<0.05). There was no significant difference in the choroidal thicknesses between the unaffected fellow eyes of NAION patients and normal eyes of healthy controls; or between the NAION eyes with resolved optic disc edema and normal eyes (P>0.05). No significant correlation between choroidal thickness (r=-0.220, -0.140, 0.110), SFCT (r=0.096, -0.148, -0.131) and logMAR BCVA, perimetry MD and RNFL was found in eyes affected by NAION (P>0.05). Conclusions The peripapillary choroidal thicknesses increase in some quadrants in NAION eyes with optic disc edema. However, the choroidal thickness of NAION eyes is the same in age and refractive error-matched normal subjects.
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[Objective] To evaluate the effect of hydromorphone for postoperative analgesia on residual carbon dioxide during recovery after laparoscopic colorectal surgery.[Methods] A total of 100 patients performed with elective laparoscopic colorectal surgery were randomly allocated into two groups according to different patient controlled intravenous analgesia (PCIA) formula:Group H contained hydromorphone 8 mg and Group M contained morphine 40 mg.Total PCIA volume was 100 mL saline with loading volume 2 mL,background volume 2 mL/h,and lockout time was set on 15 min.Analgesia infusion pump was used in the two groups half an hour before the end of surgery.Surgery time,pneumoperitoneum time,anesthesia time,extubation time,recovery time and retention time in postanesthesia care unit (PACU) were rccordcd,rcspcctively.PaCO2,the pain Visual Analogue Scale (VAS) score,Ramsay sedation score,at 30 min (T0) after pneumoperitoneum,extubation time (T1),30 min (T2),1 h (T3),2 h (T4),and 24 h (T5) after extubation,the times of PCA compressions were recorded.Anesthesia complications during waking-up period such as postoperative nausea and vomiting (PONV),shoulder pain,hypersomnia,pruritus and satisfaction degree after surgery were also recorded.[Results] Compared with group H,PaCO2 was higher at T2 ～ T4 (P ＜ 0.05);Recovery time,extubation time and the retention time in PACU were longer after surgery (P ＜ 0.05);The incidence of postoperative nausea and vomiting,shoulder pain were higher in group M (P ＜ 0.05).Compared with group M,VAS score at T1 ～ T3,and Ramsay sedation score T1 ～ T4 were decreased in group H (P ＜ 0.05).[Conclusion] Compared with morphine,hydromorphone can increase fewer residual carbon dioxide during recovery and fewer side effects for the patients caused by that after laparoscopic colorectal surgery.Hydromorphone was a safer and more effective analgesic for postoperative analgesia than morphine.
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Objective To investigate the diagnostic value of the single detection and combined detection of Epstein-Barr virus (EBV) VCA-IgM ,aspartate transaminase (AST) and alanine transaminase (ALT) in EBV current infection .Methods The VCA-IgM positive simples tested by chemiluminescence from January to October 2016 were collected .EBV-DNA was detected by RT-PCR .AST and ALT were detected by using the enzyme rate method .Then samples were divided into the EBV-DNA positive group and EBV-DNA negative group .SPSS22 .0 was used for conducting the non-parametric test .Then each indicator was analyzed by the Logistic regression and receiver operating characteristic (ROC) curve .Results The levels of VCA-IgM ,AST and ALT in the EBV-DNA positive group were higher than those in the EBV-DNA negative group ,the difference was statistically significant (P<0 .05) . VCA-IgM ,AST and ALT showed a correlation with EBV-DNA (P<0 .05) .The areas under curve (AUC) of VCA-IgM ,AST and ALT single indicator detection curve were 0 .803(95% CI:0 .735 -0 .872) ,0 .788(95% CI:0 .708 -0 .868) ,and 0 .752(95% CI:0 .671-0 .832) ,respectively ;AUC of 3-indicator combined detection were 0 .830(95% CI:0 .765 -0 .896) ,which was high than AUC of each single indicator detection .Conclusion Among the indicators in EBV current infection ,VCA-IgM is of great diagnostic value ,and is superior to AST or ALT .Furthermore ,the combined detection of these three indicators is better than single indicator detection ,which contributes to the diagnosis and prevention of EBV infection and other complicating infection .
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Objective To explore the application value of interferon gamma release assay (IGRAs)in the clinical detection of tuberculosis infected T lymphocytes.Methods Used IGRAs method to detect the 11 968 outpatients and hospitalized pa-tients from 2013 to 2016 with tuberculosis screening.According to the distribution department analysis,also of positive case detection according to age and gender were analysis and comparison and analysis on the uncertainty of results,different methods were compared.Results Among the 11 968 cases,2 048 cases were positive,the positive rate was 17.11%,and the uncertain result was 107 cases,which accounted for 0.89% of the total number.The positive rates from 2013 to 2016 were 19.65%,21.35%,15.82% and 13.56%,respectively.In the detection and screening of pulmonary and pulmonary tuberculo-sis,the positive rates of the department of respiration,the digestive department,the oncology department,the department of neurology and the department of gynecology were 22.07%,20.27%,23.38%,12.84% and 11.86%,respectively.In the positive screening,men accounted for 62.11%,women accounted for 37.89%,men were significantly higher than women.By age group,was less than or equal to 15,16~25,26~45,46~65,was more than orequal to 66 years old,positive rate were 1.96%,18.51%,16.54%,21.25% and 25.73%,respectively.Analysis of uncertain outcome data,department of respira-tion,rheumatism,department of hematology,accounted for 1.99% and 2.35%,respectively.Compared with other laboratory methods,the IGRAs method had obvious advantages.Conclusion Tuberculosis occurs in various body organs,there were differences in gender and age of Mycobacterium tuberculosis infection.IGRAs is a sensitive and specific method for rapid de-tection of Mycobacterium tuberculosis infection,although it can not be used as a diagnostic indicator,but in patients with suspected tuberculosis IGRAs has a larger clinical application value for the further diagnosis of disease.
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Objective To investigate the effects of levofloxacin on serum interlukin 6(IL-6) and interferon γ(IFN-γ) levels in the treatment of elderly patients with pulmonary tuberculosis.Methods A total of 87 senile pulmonary tuberculosis patients were collected and randomly divided into experiment group and control group.43 patients in the control group were given standardized treatment, 44 patients in the experiment group were treated on the basis of the control group were given levofloxacin, the total treatment was 6 months.By comparing serum IL-6 and IFN-γlevels changes of the patients before and after treatment and negative conversion ratio after treatment and degree of lesions changes of the two groups ,the effects of levofloxacin on pulmonary tuberculosis were explored.Results Compared with before treatment in the two groups, serum IL-6, IFN-gamma levels were significantly lower after treatment, the above indexes in experiment group were higher than those in control group (P<0.05).After 6 months treatment, negative conversion ratio in sputum bacteria in control group was 30 cases (69.77%), and 40 cases (90.91%)in experiment group, with significant difference ( P<0.05).Of the control group, the significant absorption, absorption and deterioration was respectively 22 cases (51.16%), 8 cases (18.60%), 13 cases (27.90%),of the experiment group was 31 cases (70.45%), 9 cases (20.45%), 4 cases (9.09%),respectively.The total lesions absorption rate of the experiment group (90.91%) was significantly higher than control group (69.77%) (P<0.05).Conclusion Levofloxacin in the treatment of senile patients with pulmonary tuberculosis can reduce serum IL-6 and IFN-γlevels, improve the patients'negative conversion ratio of sputum bacteria and total lesions absorption rate, has a good effect for the treatment.
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ObjectiveToinvestigatethecharacteristicsofsinglelacunarinfarct(SLI)andipsilateral multiple lacunar infarction (MLI), and the differences of risk factors and and pathologies betw een them. Methods The clinical data of al patients w ith cerebral infarction in acute internal carotid artery territory from August 1, 2008 to December 13, 2014 w ere analyzed retrospectively. Lacunar infarctions w ere screened according to the clinical manifestations and imaging findings. The patients w ere divided into a SLI, a unilateral MLI in the same blood supply area (MLI 1) and a unilateral MLI in the different blood supply area (MLI 2) group according to the number and location of the lesions show ed on diffusion w eighted imaging. Multivariate logistic regression analysis w as used to identify potential independent risk factors. Results The incidences of ipsilateral carotid plaque (73.33%vs.48.67%; χ2 =5.801, P=0.016), ipsilateral unstable carotid plaque ( 70.0%vs.42.5%; χ2 =7.192, P= 0.007 ), and ipsilateral carotid stenosis ≥50%(16.67%vs.1.77%; χ2 =8.327, P=0.004) of the MLI 1 group w ere significantly higher than those of the SLI group; the incidence of atrial fibril ation of the MLI 2 group w as significantly higher than that of the SLI group (40.0%vs.0.88%; χ2=15.887, P<0.001); there w ere no significant differences in the remaining risk factors among each group. Multivariate logistic regression analysis showed that atrial fibrilation (odds ratio [OR] 14.452, 95% confidence interval [CI] 1.558-134.011; P=0.019) and ipsilateral carotid stenosis ≥50% (OR 11.483, 95%CI 2.202-59.891; P=0.011) w ere the independent risk factors for MLI. Conclusions MLI may have different risk factors and pathogeneses w ith SLI. Atherosclerotic lesions and embolism are the important pathogeneses of MLI, w hile SLI is not.
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Objective To assess the diagnostic value of 18 F?FDG PET/CT imaging for primary pul?monary lymphoepithelioma?like carcinoma (LELC). Methods A total of 19 patients (10 males, 9 fe?males;average age 56.4 years) with suspected primary pulmonary LELC undergone whole?body 18F?FDG PET/CT and chest contrast CT scan were enrolled in this retrospective study. The SUVmax and uptake pat?terns of FDG, the histological types and the clinical stages were recorded. Image characteristics of contrast CT and FDG PET/CT were observed, and the diagnostic efficiency was calculated. Two?sample t test and one?way analysis of variance were used to analyze the results. Results The diagnostic sensitivity and spe?cificity of LELC were 12/13 and 4/6 for FDG PET/CT. The SUVmax of LELC lesions was significantly differ?ent from that of other lung malignant tumors or lung benign lesions (F=3.67, P<0?05). The lesion had longer diameter, lower CT density, higher SUVmax in stage Ⅳ patients, compared with that in stageⅠ-Ⅲpatients ( F=7.01, P<0.05) . The significant difference of SUVmax was found between lesions with ring up?take and lesions with other uptake types (3.94±0.67 vs 2.86±0.35; t=4.07, P<0?05). The SUVmax was higher in Schmincke tumors when compared with that in tumors of Regaud subtype ( 3. 61 ± 0. 71 vs 2. 76 ± 0?29; t=2.99, P<0.05) . Conclusion 18 F?FDG PET/CT could be an accurate method in differential diag?noses of primary pulmonary LELC.