ABSTRACT
Objective:To investigate the imaging features of solitary bone plasmacytoma (SBP) and to improve the diagnosis of SBP.Methods:The imaging and clinical data of 8 cases clinically diagnosed as SBP at different sites from September 2012 to September 2020 in Yuanping First People's Hospital of Shanxi Province were retrospectively analyzed. Imaging examinations included CT, magnetic resonance imaging (MRI) plain scan and enhanced MRI scan.Results:The lesion sites of 8 patients included 3 cases of thoracic vertebrae, 2 cases of lumbar vertebrae, 2 cases of skull, and 1 case of rib. Among them, 1 case was misdiagnosed as thoracic metastatic tumor, 1 case as thoracic tuberculosis, 1 case as lumbar lymphoma and 1 case as cranial meningioma. Osteolytic destruction of bone was found in all cases accompanied by expansible changes of bone and soft tissue masses. There were 5 cases of vertebral bodies compressed and flattened; CT showed equal/low density, T1WI showed equal/low signal, T2WI showed low/slightly high signal, and 2 cases showed typical "mini brain sign". There were 2 cases of skull with slight hyperintensity on CT, isointensity on T1WI, and equal/mixed hyperintensity on T2WI. The rib cases showed isodensity on CT, T1WI showed isointensity, T2WI showed slightly high intensity. The lesions of 4 SBP patients showed obvious uniform enhancement on MRI enhanced scan.Conclusions:SBP at different sites can show osteolytic destruction with uniform enhancement of lesions and soft tissue masses. "Mini brain sign" is the SBP-specific imaging sign of the spine.
ABSTRACT
Objective:To compare the quality and diagnostic utility of the three sequences including fast spin echo (FSE), multi-acquisition variable resonance image combination selective (MAVRIC-SL), and isotropic MAVRIC-SL (iso MAVRIC-SL), in evaluating the intervertebral foramen and spinal canal in patients after lateral lumbar interbody fusion (LLIF).Methods:Totally 30 patients after LLIF were enrolled prospectively from May to June 2020 in the Second Hospital of Shanxi Medical University. The patients underwent MRI of the lumbar spine including sagittal MAVRIC-SL and iso MAVRIC-SL sequence three-dimensional volume imaging, and the axial spinal canal level images were reconstructed. FSE sequence sagittal T 1WI and axial T 2WI images were acquired simultaneously. The sagittal and axial images were subjectively graded for visualization of the intervertebral foramen and spinal canal. The artifact area and SNR were measured. The Friedman M test was used to compare the differences in image quality scores, artifact area and SNR among the three sequences. Results:Nonparametric test results showed significant differences in sagittal and axial image quality scores among the three sequences (both P<0.001). Sagittal image quality scores of MAVRIC-SL [4 (4, 4) points] and iso MAVRIC-SL [4 (4, 4) points] were higher than those of FSE T 1WI sequence [3 (3, 3) points, both P<0.001]. The quality scores of MAVRIC-SL and iso MAVRIC-SL showed no significant differences ( P=1.000). The axial image quality score of iso MAVRIC-SL[5 (5, 5) points] were higher than those of MAVRIC-SL [4 (4, 4) points] and FSE T 2WI [3 (3, 3) points, both P<0.05]. The iso MAVRIC-SL images enabled a significantly improved reduction in the artifact area and SNR compared to the MAVRIC-SL and FSE sequence (all P<0.05). Conclusion:The iso MAVRIC-SL acquisitions enhance visualization of the intervertebral foramen and spinal canal and decrease metal artifacts compared with MAVRIC-SL and FSE acquisitions.
ABSTRACT
Objective To investigate the epidemiology and relevant risk factors of invasive fungal infection (IFI) in hospital old patients for non-respiratory tract. Methods Seventy-eight patients of IFI in non-respiratory tract were enrolled in this investigation. The incidence and risk factors of IFI were analyzed by prospective case-control study. Results In 78 old patients, 84 strains were isolated from different parts, and the most was Candida spp 82 strains (97.62%,82/84), followed by Candida albicans 55 strains (67.07%,55/82), Candida glabrata 13 strains ( 15.85%, 13/82), Candida krusei 6 strains (7.32%, 6/82), Candida tropicalis 4 strains (4.88% ,4/82), Candida parapsilosis 3 strains (3.66% ,3/82), Candida lusitaniae 1 strain ( 1.22%, 1/82). Aspergillus 2 strains (2.38%,2/84). Multivariate Logistic regression analysis showed that age, pathogen detection time, underlaying disease,glucocorticoids, immunosuppressants were the risk factors for IFI in non-respiratory tract. Conclusions Candida albicans is the main pathogens of Candida infections in old patients. To efficiently control the risk factors should be emphasized in old patients, including early diagnosis and treatment underlying diseases, appropriate use drugs, right to shorten hospital stay.
ABSTRACT
Objective To characterize 16S rRNA methylase encoding genes associated with aminoglycoaides resistance, gene cassettes of class Ⅰ integrons of the multidrug-resistant Acinetobctcter spp. The sixty one Acinetobacter isolates were collected at the Second Hospital of Shanxi Medical Uni versity from July, 2007 to May, 2008. Methods Species identification was confirmed by sequence analysis of the blaOXA-51-like gene and 16S-23S rRNA gene space-region. Antimierobial susceptibility tests were performed by agar dilution method. 16S rRNA methylaae encoding genes and gene cassettes associated with integrons were amplified by PCR method. Results Among the sixty one strains, there were fifty five of Acinetobacter baumannii, three genospecies 3TU, one 13TU, one Aeinetobaeter ealcoacetieus, and one Aeinetobaeter haemolytieus. Forty eight isolates showed high-level resistance to three aminoglyeosides, including amikaein, tobramyein and gentamicin. The armA gene was found in 47 isolates and all isolates were negative for rmtA, rmtB, rmtC and rmtD genes. The Intl gene was found in 27 isolates. The gene cassettes contained arr-3, accA4,ctacCI ,catB8, aadA1 or dfrA12 genes. According to the PFGE DNA patterns, 5 distinct clones of armA-pasitive strains were identified. Clone A and Clone B were the dominant clones, widely distributed among different divisions. Condnsions 16S rRNA methylase encoding gene (armA) distributed widely in muhidrug-resistant Acinetobacter spp. The armA gene is not located in class Ⅰintegron. The class Ⅰ integron carries multiple resistant genes associated with aminoglycosides and chloramphenieol resistance.PFGE analysis suggests that armA-pesitive strains are widely spread in our hospitaL Effective infection control measure should be conducted in order to control the outbreak of resistant bacteria.
ABSTRACT
OBJECTIVE To investigate the current status,the clinical features and the pathogens of invasive fungal infections in hospital in order to provide clinical treatment based on identification and susceptibility test.METHODS The fungus-cultured positive cases among the discharged patients from Jan 2004 to Nov 2006,were analyzed according to their definite diagnosis of invasive fungal infections under the items,such as the patients age,underlying disease,sample,strain,and species distribution.RESULTS The rates of invasive fungal infections were 4.26%.There were 2221 fungus strains belonged to 8 species in all samples;the patients age was 7-96 years with 2 kinds of various underlying diseases;the age of 2221 cases was 60 years old,mainly senile patients with various diseases accounted for 68.29%.Lower respiratory tract was the most frequent infection site.The main pathogens of invasive fungal infections were Candida spp(93.38%).Strains of Candida albicans were the most frequent organism isolated accounted for 66.19% of all the isolates.C.glabrata,C.krusei and C.tropicalis accounted for 9.19%,8.10% and 4.50%,respectively,the others accounted for only 6.32%.The main infected sites were lower respirtory tract,urinary tract and digestive tract.CONCLUSIONS Candida spp are still the main pathogens of invasive fungal infections.The epidemiological properties of invasive fungal infections is changed.The incidence of non-C.albicans and the Aspergillus strains that arouse invasive infections is increasing recently.
ABSTRACT
15.0%.CONCLUSIONS The most common pathogens causing nosocomial infection are Gram-negative bacteria.The resistance rates are high.Antibiotics policy is urgently needed in order to delay the resistance onset development.