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Objective To investigate the clinical features and prognostic factors in patients with acquired immunodeficiency syndrome (AIDS) and liver abscess.Methods The clinical data of AIDS patients with liver abscess admitted in Beijing You-an Hospital during January 2013 to December 2017 were retrospective analyzed to reveal the clinical manifestations,etiologies,imaging features,therapeutic effects and prognostic factors.T test,x2 test or Fisher exact test were used for statistical analyses.Results A total of 76 patients were recruited.The most common clinical manifestations were fever (72 cases),chills (48 cases),anorexia (42 cases) and abdominal pain (35 cases).Liver abscesses were mainly located in right lobe (57 cases),then in left lobe (11 cases),in both right and left lobes (6 cases) and in caudate lobe (2 cases).Lobulation or division was seen in 19 cases and gas formation was seen in 5 cases.Single abscess was identified in 56 cases.Positive culture results were obtained in 15.5％ (9/58) from liver pus and 6.0％ (4/67) from blood samples.Thirteen strains of pathogens were detected by liver pus culture,including 9 strains of Staphylococcus,3 strains of Candida and 1 strain of Mycobacterium.Six strains of pathogens were detected by blood culture,including 5 strains of Staphylococcus and 1 strain of Corynebacterium.The main complications included acute kidney injury (10 cases) and septic shock (6 cases).Sixty-one cases were treated with antibiotics plus imaging-guided percutaneous aspiration,drainage or surgery,of whom 57 cases were effective.Fifteen cases were treated with antibiotics alone,of whom 12 cases were effective.Septic shock (OR =70.16,95％ CI:4.77-1 032.06,P ＜0.01),respiratory failure (OR =68.41,95％ CI:2.40-1 946.53,P =0.01) and gas formation (OR =23.36,95％ CI:1.30-420.16,P =0.03) were independent risk factors for poor prognosis.Conclusions The clinical features of AIDS patients with liver abscess are uncharacteristic.Bacteria are the main pathogens.Septic shock,respiratory failure and gas formation are independent risk factors for poor prognosis.Imagingguided percutaneous aspiration,drainage combined with antibiotic therapy is safe and effective.
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Objective The objective of this study was to investigate the relationship between the molybdenum target imaging features and clinical signs of mammography,and the expression of HER-2 receptor in breast cancer patients with positive receptors of estrogen and progesterone. Methods One hundred and eleven patients with estrogen and progesterone receptor-positive breast canc-er who were admitted to our hospital from July to September 2017 were examined with mammography before operation. Immunohisto-chemical analysis was performed on breast cancer tissues. Pathological features and features related to mammography were analyzed af-ter operation. The relationship between clinicopathological features and mammography-related signs,and HER-2 expression was al-so analyzed statistically. Results Of the 111 patients,34 were HER-2 positive patients. There were significant difference between the observed indicators and the over-expression of HER-2(P<0. 05). These indicators included lymph node metastasis,calcifica-tion of the mass,margin of the mass,the shape of calcification,and the blood status of vessels. The mammography of patients with tri-ple positive breast cancer is more likely to manifest as lymph node enlargement,mass with calcification or simple calcification,margin-al burrs,granular calcification,and vascular thickening. Conclusion The expression of HER-2 in breast cancer patients with posi-tive estrogen and progesterone receptors can be reflected to some extent by lymph node metastasis,tumor with calcification,tumor mar-gin,calcification,calcification morphology and peripheral blood vessel thickening. In terms of clinical conditions,The biological behav-ior and characteristics of tumor can be inferred based on the clinicopathological features of the patient and the imaging findings of the mammography,providing a direction for the treatment and evaluation of prognosis in breast cancer patients.
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Objective To investigate the incidence and potential risk factors of linezolid (LZD) related thrombocytopenia (TP) in patients with liver cirrhosis (LC). Methods Clinical data of LC patients treated with LZD for at least 1 dose (600 mg per 12 h) between January 2013 and May 2017 were retrospectively collected and analyzed to investigate the incidence and risk factors of LZD-related TP defined as platelet count during LZD therapy ≤ 50×109/L or a decline by ≥25％ of the baseline level. Results A total of 52 patients with LC were included in this study. The cumulative incidence of LZD-related TP was 51.9％ (27/52), of which 85.2％ (23/27) was severe TP (decline of platelet count by ≥50％ of the baseline level). Multivariate logistic regression analysis showed that the baseline platelet count ≤110 ×109/L (OR=6.989, 95％ CI: 1.192-40.971, P=0.031), LZD course ≥ 7 d (OR=9.478, 95％ CI: 1.349-66.587, P=0.024) and LZD dose ≥ 17 mg·kg-1·d-1 (OR=0.062, 95％ CI: 0.010-0.383, P=0.003) were independent risk factors of LZD-related TP in LC patients. Kaplan-Meier analysis revealed that the overall median time from the initiation of LZD therapy to in-hospital death was 18 days in TP patients and 13 days in non-TP patients without significant difference (P＞0.05). Cox proportional-hazards regression revealed no significant correlation between the in-hospital mortality and LZD-related TP in LC patients (P＞0.05). Conclusions Patients with LC are at high risk of LZD-related TP, but not associated with organ hemorrhage during LZD therapy and in-hospital mortality. Platelet count should be monitored more closely during LZD therapy for LC patients with lower baseline platelet count and longer LZD course.
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<p><b>BACKGROUND</b>Idiopathic pulmonary fibrosis (IPF) is a lethal chronic interstitial lung disease (ILD) of unknown cause and having a variable and unpredictable course. This study aimed to summarize the clinical features and follow-up outcomes and to identify potential factors useful for the assessment of prognosis in IPF.</p><p><b>METHODS</b>Two hundred and ten patients hospitalized and diagnosed as IPF in our unit from January 1999 to June 2007 were enrolled into this study. The baseline demographic, clinical, radiologic and physiologic characteristics were summarized. Clinical follow-up data until February 2010 were collected, and the median survival time and 1-, 2-, and 5-year survival rates, as well as the influences of the summarized baseline variables on the prognosis were analyzed.</p><p><b>RESULTS</b>The age at diagnosis as IPF was (64 ± 10) years, the duration before diagnosis of 106 patients (50%) was shorter than 2 years, and 73% were males. One hundred and forty-five patients (69%) had a history of smoking with a median pack-year of 18. Eighty-nine patients (42%) had emphysema and 62 patients (29%) pulmonary arterial hypertension (PAH). One hundred and twenty-four patients were followed up, of which 99 patients died from various causes including respiratory failure related to IPF (93%). The follow-up period was (21 ± 23) months. The median survival time was 38 months. The 1-, 2-, and 5-year survival rates were 61%, 52%, and 39%, respectively. Multivariate analysis showed clubbing, PAH, duration from initial onset to diagnosis, and forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) were independent prognostic indicators of IPF.</p><p><b>CONCLUSION</b>IPF patients who have clubbing, PAH, a higher FEV1/FVC, and a short duration from initial onset to diagnosis have a poorer outcome.</p>