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ObjectiveTo explore the relationship between the intestinal flora and the impairment of liver and kidney in HIV-infected men who have heterosexual sex with healthy women. MethodsFecal samples from 41 HIV-infected heterosexual men who have sex with women （PMSW） and 43 age- and BMI-matched healthy heterosexual men who have sex with women （NMSW） were collected and subjected to 16S rDNA sequencing. The blood levels of AST， ALT， TBIL， UREA， Cr， UA， β2-MG and other liver and kidney function indicators were measured. Bioinformatics methods were used to analyze the characteristics of the intestinal flora of the patients in these two groups， to compare the differential bacteria strains， and to analyze their correlation with liver and kidney function indicators. ResultsIn comparison with NMSW， the alpha diversity of intestinal flora was decreased in PMSW， and the beta diversity analysis showed significant differences in flora characteristics between the two groups （P<0.05）. The abundance of Clostridium， Phylum thick-walled， Trichosporon， and Clostridium tumefaciens decreased but Fusobacteriota increased （LDA score >4）. The comparison of liver and kidney function indexes revealed that AST， β2-MG levels were higher in PMSW than in NMSW， while TBIL was lower in PMSW than in NMSW. The number of patients with abnormal β2-MG was much higher in PMSW than in NMSW， and the difference was statistically significant （P<0.001）. It was also found that AST was negatively correlated with Clostridium （P<0.05）； TBIL was negatively correlated with Clostridium and positively correlated with Phylum thick-walled and Trichosporon （P<0.05）. β2-MG was negatively correlated with Phylum thick-walled， Clostridium， Trichosporon and Rumenococcus （P<0.05） and positively correlated with Clostridium （P<0.05）. ConclusionIn PMSW group， the alpha diversity of the flora is decreased. AST and β2-MG levels are increased， and TBIL level is decreased. These changes were significantly correlated with different strains of bacteria in the intestinal flora.
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Objective:Based on the artificial intelligence (AI) technology in endoscopy and the internet platform, to explore and construct a safe, standardized, scientific and rigorous database for digestive endoscopy, and to provide reference and evidence for the data quality control of AI in digestive endoscopy in China.Methods:After referring to relevant guidelines and standards, data collection and labelling standards of digestive endoscopy of 12 common gastrointestinal diseases were determined. The software of online collection and labelling of multi-center digestive endoscopy data in Shandong Province was developed. Endoscopic equipment with a domestic market share of >5% was used and dozens of experienced endoscopists from 9 medical centers in Shandong Province were uniformly trained for data labelling. From July 2019 to July 2020, the endoscopic examination data from 9 medical centers including Qilu Hospital of Shandong University, Shandong Provincial Hospital , Liaocheng People′s Hospital, Linyi People′s Hospital, Weihai Municipal Hospital, Taian City Central Hospital, Binzhou Medical University Hospital, Yantai Yuhuangding Hospital and Qilu Hospital of Shandong University (Qingdao) were prospectively and continuously collected and labeled. The optimized, desensitized, and generalized data were uploaded to the server. After the file synchronization, data processing, and expert review, a multi-center digestive endoscopy AI database with standard data collection and labelling in Shandong Province was constructed, namely cloud platform. Descriptive methods were used for statistical analysis.Results:The collection and labelling standards for multi-center digestive endoscopy AI data in Shandong province was established. The software of online collection and labelling of multi-center digestive endoscopy AI data in Shandong province was developed. The database in Shandong province was successfully constructed. In the database, 43 010 lesions, 40 353 images, and 11 289 examinations were labeled. Among them, there were 2 906 cases of early esophageal cancer, 2 912 cases of early gastric cancer, 2 397 cases of early colorectal cancer, and 9 773 cases of colorectal polyps (5 539 cases of adenomatous polyps, 1 161 cases of non-adenomatous polyps and 3 073 case of undetermined polyps).Conclusions:The multi-center AI cloud platform for digestive endoscopy in Shandong Province adopts unified standards and collection and labeling software, which ensures the safety and standardization of endoscopy data. It provides a reference and basis for the construction of a quality control system for standardized data collection and labelling of digestive endoscopy AI data in our country and for the third-party data supervision.
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Objective To compare the clinical effect of the two surgical methods of posterior pedicle screw fixation decompression in treatment of thoracolumbar burst fractures,and in order to provide the basis for choosing the rational treatment.Methods Retrospectively analyzed the clinical data of 98 patients with thoracolumbar burst fractures underwent surgery of posterior pedicle screw fixation decompression from January 2007 to January 2011.Fifty-six patients were given posterior fixed indirect decompression surgery (indirect decompression group) and 42 patients were given posterior fixed direct decompression (direct decompression group).The patients were followed up for (1.03 ± 0.36) years after surgery,the image,recovery of neurological function,postoperative complications and capacity for independent living of the two groups were compared and evaluated.Results After surgery,the vertebral height ratio,Cobb angle,canal compromise rate in indirect decompression group were (91.67 ± 26.19)％,(10.10 ± 2.89)°,(18.61 ±5.32)％,in direct decompression group were(86.23 ± 24.64)％,(11.98 ± 3.42)°,(22.37 ± 6.39)％.There was significant difference compared with before surgery (P ＜ 0.05) and no significant difference between two groups (P ＞0.05).After surgery,the neurological function of the two groups were improved,and the improvement in indirect decompression group was better than that in direct decompression group (P ＜ 0.05).The postoperative complications ratio in indirect decompression group was 23.2％ (13/56),significantly lower than that in direct decompression group[83.3％(35/42)](x2 =10.370,P＜ 0.01).There was 60.7％(34/56)patients with capacity for independent living in indirect decompression group,significantly higher than that in direct decompression group [40.5％ (17/42)] (x2 =4.329,P ＜ 0.05).Conclusion The posterior pedicle screw fixation indirect decompression in treatment of thoracolumbar burst fractures is a feasible operation method,and is worth to utilize in clinic.
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Objective To investigate the efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar disc herniation. Methods Under local anesthesia,48 patients(oberserve group) with single lumbar disc herniation were treated by percutaneous endoscopic lumbar discectomy, and the spinal cord and the nerve root were decompressed under the guidance of the C-arm X-ray machine. The visual analogue scale (VAS) of preoperative and postoperative 1 month and final follow up of patients was used for the pain assessment, and at the same time the modified MacNab criteria was used for efficacy assessment, compared with 40 cases of percutaneous endoscopic discectomy patients( control group). Results Observe the operation time( 62.7 ± 12. 3) min and hospital stay (4.6 ± 1.2) d was significantly lower than the control group (87. 2 ± 16. 7) min, (8. 9 ± 3. 7) d, after 1 month (3.13 ±0.76) and the final follow-up( 1.35 ±0.23) VAS scores were lower than the control group(4.85 ± 1. 24) (2.64 ±0. 81) ( P ＜ 0. 05) , using modified Macnab criteria to evaluate the clinical efficacy, excellent observation group was 77.1 % , significantly higher than 62.5 % (P ＜ 0.05 ). Conclusion The efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar disc herniation was positive,but it should be strictly to master surgical indications.