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Ultrasound examination has the advantages of non-radiation, non-invasive, low cost and high efficiency, and is the most commonly used method of liver imaging examination. In recent years, the application of computer vision technology to the intelligent analysis of ultrasound images has become a research hotspot in the field of intelligent healthcare. Through large-scale data training, the intelligent analysis model of ultrasound omics based on machine learning algorithm can assist clinical diagnosis and therapy, and improve the efficiency and accuracy of diagnosis. Based on the literature, the authors summarize the application proprect of computer vision technology assisted ultrasonography in the evaluation of diffuse liver lesions, focal liver lesions, microvascular invasion of liver cancer, postoperative recurrence of liver cancer, and postoperative therapy response to trans-catheter arterial chemoembolization.
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Objective:To report a case of acute kidney injury caused by rhabdomyolysis and summarize its etiology, pathogenesis, and treatment strategy.Methods:The clinical data of a case of rhabdomyolysis complicated by acute kidney injury admitted to Affiliated Huadu Hospital of Southern Medical University on August 30, 2020, were collected, including clinical manifestation, auxiliary examination, and disease outcome. Referring to the previous literature reports of rhabdomyolysis complicated by acute kidney injury, this paper discusses its etiology, monitors and analyzes some indicators such as serum creatinine, blood urea nitrogen, creatine kinase, myoglobin, and 24-hour urine volume during the treatment, and summarizes the clinical diagnosis and treatment ideas of the disease.Results:This case developed an intestinal infection after an unclean diet, which induced rhabdomyolysis and acute kidney injury. Renal pathology after renal biopsy showed that renal biopsy result was consistent with an acute tubulointerstitial injury caused by myoglobin tubular nephropathy. The biochemical indexes such as creatine kinase and myoglobin decreased rapidly after ordinary hemodialysis, but the levels of serum creatinine and blood urea nitrogen did not decrease markedly, and there was continuous oliguria. After switching to hemodialysis filtration and continuous intensive dialysis treatment, the levels of serum creatinine and blood urea nitrogen decreased rapidly, the amount of urine increased gradually, and finally, the renal function recovered.Conclusion:For acute kidney injury caused by rhabdomyolysis, early sufficient blood purification can accelerate the clearance of myoglobin, promote the recovery of the injured kidney, and improve the prognosis of the disease.
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ObjectiveTo investigate the comprehensive spoken communication performance of children with disabilities, and explore the related individual and environmental factors. MethodsFrom August to November, 2022, questionnaires of Communication Function Scale for Children based on ICF-CY were distributed online to parents of healthy children and children with disabilities aged two years to five years and eleven months in Shanghai, Nanjing and other areas. ResultsA total of 500 copies were sent out, and 407 valid questionnaires were returned, including 84 healthy children, 85 with hearing impairment, 119 with mental retardation, 35 with cerebral palsy and 84 with autism. There were significant differences in the comprehensive spoken communication function performance among the children with different impairment types (F = 127.618, P < 0.001). The comprehensive spoken communication ability was significantly poorer in the children with disabilities than in the healthy children (P < 0.05), and the ability was better in hearing-impaired children than in the children with other disabilities (P < 0.05). The higher the education of mother (r = -0.311, P < 0.001) and father (r = -0.280, P < 0.001), and family annual income (r = -0.228, P < 0.001), the better the children's comprehensive spoken communication performance; the children's comprehensive spoken communication performance was better when the family used Putonghua as unified communication language (r = 0.210, P < 0.001). ConclusionThe comprehensive spoken communication performance for children with disabilities is heterogeneous among different impairment types, and is affected by parents' education, family annual income, and family communication language.
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Objective:To explore the clinical and chest CT features of anti-interferon(IFN)-γ autoantibodies-positive talaromycosis marneffei (TSM) infection in human immune deficiency virus (HIV)-negative patients.Methods:Clinical data and chest CT findings including pulmonary manifestations, bronchial changes, pleural changes, and extrapulmonary manifestations in 54 HIV-negative patients with Talaromyces marneffei (TM) infection and positive anti-interferon-γ(IFN-γ) autoantibody in the First Affiliated Hospital of Guangxi Medical University from December 2012 to September 2019 were retrospectively analyzed. CT score was rated for the degree of lung involvement, and the difference of involvement at different regions of the lung were compared. Results:Of 54 patients, 46 cases had fever, 43 cases had cough and expectoration, 28 cases had cutaneous or subcutaneous lesion, and 19 cases had arthritis or arthralgia. Laboratory tests showed that the value of CD4/CD8 decreased in 29 cases and platelet count increased in 32 cases. Only one of 54 patients had no abnormal findings on chest CT. In the remaining patients, chest CT manifestations were diverse, mainly presenting as fibrous cord-like lesions (87.0%, 47/54), lymph node enlargement (75.9%, 41/54), sporadic nodules (74.1%, 40/54), patchy consolidation (72.2%, 39/54), pleural effusion (59.2%, 32/54), and consolidation lesions associated with air bronchogram (63.0%, 34/54). Most of the lesions showed bilateral distribution (77.8%, 46/54), and involved both peripheral and central regions in 38 cases (70.4%, 38/54). CT score showed that there was no significant difference in the degree of involvement at different regions of the lung.Conclusions:The clinical and imaging manifestations of anti-IFN-γ antibody-positive patients with TM infection are characteristic. Most TSM patients with positive anti-IFN-γ antibody have fever, cough and expectoration. The main features of chest CT are cord focus, nodules, consolidation and pleural effusion. Lymph node enlargement often coexists with the above signs, and most of the lesions are distributed bilaterally.
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Background In recent years, the incidence of metabolic syndrome (MS) is increasing significantly in China. Some studies have found that temperature is related to single metabolic index, but there is a lack of research on associated mechanism and identifying path of the influence of temperature on MS. Objective Based on the data of Guangdong Province, to investigate the effect of temperature on MS and its pathway. Methods A total of 8524 residents were enrolled by multi-stage random sampling from October 2015 to January 2016 in Guangdong. Basic characteristics, behavioral characteristics, health status, and physical activity level were obtained through questionnaires and physical examinations, and meteorological data were obtained from meteorological monitoring sites. We matched individual data both with the temperature data of the physical examination day and of a lag of 14 d. A generalized additive model was used to explore the exposure-effect relationship between temperature and MS and its indexes, calculate effect values, and explore the effects of single-day lag temperature. Based on the literature and the results of generalized additive model analysis, a path analysis was conducted to explore the pathways of temperature influencing MS. Results The association between daily average temperature on the current day or lag 14 day and MS risk was not statistically significant. When daily average temperature increased by 1 ℃, the change values of fasting blood-glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high density lipoprotein cholesterol (HDL-C) were −0.033 (95%CI: −0.040-−0.026) mmol·L−1, −0.662 (95%CI: −0.741-−0.583) mmHg, −0.277 (95%CI: −0.323-−0.230) mmHg, and −0.005 (95%CI: −0.007-−0.004) mmol·L−1 respectively. The effects of average daily temperature on FBG, blood pressure, HDL-C, and waist circumference lasted until lag 14 day. The effects of daily average temperature on SBP and DBP were the largest on the current day. Daily average temperature of current day had direct and indirect effects on FBG and SBP. Temperature had an indirect effect on TG, and the intermediate variables were waist circumference and FBG, with an indirect effect value of −0.011 (95%CI: −0.020-−0.002). The indirect effects of daily average temperature on SBP, FBG, and TG were weak. Conclusion There is no significant correlation between temperature and risk of MS, and daily average temperature of current day could significantly affected blood pressure and FBG with a lag effect. Daily average temperature of current day has indirect effects on FBG and TG.
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OBJECTIVE To excavate and evaluate β-blockers associated with acute renal failure（ARF）signal. METHODS Using the report odds ratio （ROR）method and Bayesian confidence interval progressive neural network （BCPNN）method，signal detection and analysis were performed for 4 kinds of β-blockers（metoprolol，bisoprolol，atenolol，nebivolol）associated with ARF Δ 基金项目：重庆市临床药学重点专科建设项目 （No.渝卫办发 in FDA adverse event reporting system （FAERS）from the two 〔2020〕68号）；重庆医科大学未来医学青年创新团队发展支持计划项 dimensions of Standard International Dictionary of Medical 目（No.W0081） Terms （MedDRA） analysis query （SMQ） term set and ＊药师，硕士研究生。研究方向：药物警戒。电话：023-68485161。 preferred term （PT） level terms. When the two methods E-mail：2020121624@stu.cqmu.edu.cn detected positive signals at the same time ，it indicated that # 通信作者：主任药师，硕士生导师。研究方向：临床药学、药物警 suspicious signals were detected. RESULTS Totally 14 328 戒。电话：023-63625666。E-mail：jiayuntaomail@hospital.cqmu.edu.cn ARF reports of 4 kinds of β-blockers were retrieved within the ·1380· China Pharmacy 2022Vol. 33 No. 11 中国药房 2022年第33卷第11期 narrow sense of “acute renal failure ”in SMQ term set ，of which men （6 964）were more than women （6 206）. The age of patients was mainly concentrated in the middle-aged and elderly （≥45 years old ），and serious adverse events accounted for 77.23％. The results of signal retrieval based on SMQ term set showed that ROR values and 95％ confidence intervals of metoprolol ，bisoprolol， atenolol and nebivolol detected by ROR method were 2.58（2.51，2.65），5.30（5.14，5.47），2.80（2.69，2.91）and 3.28（3.04， 3.53）respectively. The signal components （IC）detected by BCPNN method and the lower limit of IC were 1.29（1.25），2.26 （2.22），1.42（1.36）and 1.64（1.53）respectively，suggesting suspicious signals were detected in these four kinds of β-blockers associated ARF. The results of signal detection based on PT level terms showed that 37 positive signals were detected by ROR method，38 positive signals were detected by BCPNN method ，and 36 suspicious signals were detected by the two methods at the same time. For each drug ，12 suspicious signals of metoprolol were detected at the same time ，9 suspicious signals of bisoprolol and atenolol were detected at the same time ，and 6 suspicious signals of nebivolol were detected at the same time ；the number and type of signals were different among the 4 kinds of drug. CONCLUSIONS Four kinds of β-blockers may cause ARF. Compared with metoprolol and atenolol ，bisoprolol and nebivolol have strong statistical correlation with ARF ，suggesting that medical personnel should pay attention to the possible renal related adverse reactions of these drugs in the process of clinical use.
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OBJECTIVE To provide reference for the safety of drug use in children and the rational drug use management strategies by health administration departments. METHODS A self-designed questionnaire was used to investigate the cognition of antibiotics and the parents ’behavior of children ’s use of antibiotics ，using online and offline questionnaires. Univariate analysis was carried out on the scores of respondents ’cognition，and multivariate Logistic regression analysis was carried out on the factors affecting parents ’behavior of children ’s use of antibiotics. RESULTS A total of 1 068 questionnaires were distributed ，and 993 valid questionnaires were recovered ，with the effective recovery rate of 93.0％. Among the respondents ，43.2％ of the parents ’ behavior of children ’s use of antibiotics in the past 6 months. The score of respondents ’cognition，high treatment cost and cumbersome treatment procedures ，easy access to antibiotics ，certain medication experience ，the recommendation of pharmacists in drug store ，the recommendation of relatives and friends and the publicity of mass media were positively correlated with parents ’ behavior of children ’s use of antibiotics （P＜0.05）. CONCLUSIONS The rate of the parents ’in Sichuan-Chongqing area is high ， which is the result of a combination of several factors. Reducing the risk of behavior of children ’s use of antibiotics requires the joint efforts of the government ，medical institutions and the public. The parents ’cognition towards antibiotics should be improved ，and the acquisition of antibiotics should be standardized so as to reduce unreasonable use of antibiotics.
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Immunotherapy is becoming an effective and less invasive strategy that can be applied to the treatment of various malignancies. Lentiviral vectors (LVs) have shown great potential in immunotherapy as they can stably integrate relatively large foreign DNA, and effectively transduce dividing and non-dividing cells. Clinical application needs high quality LVs, and therefore strict quality control of the final products is necessary to ensure their purity, efficacy and safety. The quantitative detection of LVs is among the key parts of product development and quality control. In this paper, the existing methods for quantitative detection of LVs are summarized, including fluorescence activated cell sorter (FACS), P24 enzyme-linked immuno sorbent assay (P24 ELISA), real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), nanoparticle tracking analysis (NTA), tunable resistive pulse sensing(TRPS) and virus counter(VC).Their advantages and disadvantages are listed, and future development and challenges are discussed.
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Humans , Genetic Vectors/genetics , Immunotherapy , Lentivirus/genetics , Neoplasms , Transduction, GeneticABSTRACT
Objective@#To investigate the prevalence and risk factors of neck and shoulder pain (NSP) among automobile manufacturing workers and to provide a theoretical basis for prevention of NSP.@*Methods@#From November 5 to November 19, 2017, a total 446 works who had worked for more than one year were recruited from an automobile plant by cluster sampling method. Chi square test and unconditional logistic regression were used to exam the relation between influencing factors and NSP.@*Results@#The annual prevalence rate of NSP was 34.8%. Multifactor regression analysis showed that age、work fatigue、department staff shortages、lifting heavy objects in awkward positions、neck flexion foreword and prolong sitting position work were the risk factors of NSP (OR=2.18, 95%CI:1.49~3.18; OR=4.52, 95%CI:1.27~16.00; OR=1.66, 95%CI:1.04~26.68; OR=2.10, 95%CI:1.16~3.81; OR=2.25, 95%CI:1.39~3.66; OR=2.42, 95%CI:1.06~5.56) and work break was the benefit factors of NSP (OR=0.58, 95%CI:0.36~0.94) .@*Conclusion@#The annual prevalence rate of NSP among automobile manufacturing workers was high. Lifing heavy objects、awkward working positions and unreasonable work arrangement were the major risk factors of NSP, and work break can effectively reduce the risk of NSP. Effective ergonomic intervention should be carried out to prevent the occurrence of NSP.
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OBJECTIVE: To investigate the prevalence and influencing factors of low back pain in workers in automobile manufacturing plants. METHODS: A judgment sampling method was used to select 394 workers with working length ≥1 year in an automobile manufacturing plant as study subjects. A questionnaire survey was conducted to investigate the prevalence of low back pain in these workers using the Nordic Musculoskeletal Disorders Questionnaire. RESULTS: The prevalence of low back pain in these study subjects was 28. 9%( 114/394). The multivariate logistic regression analysis results showed that the relative risk ranked from high to low is as follow: uncomfortable working posture [Odds ratio( OR) =7. 31,95% confidence interval( 95% CI) = 2. 92-18. 28],feeling tired after work( OR = 5. 34,95% CI = 1. 22-23. 32],the commu time more than 30 minutes( OR = 2. 76,95% CI = 1. 38-5. 52),insufficient operating space( OR = 2. 22,95% CI = 1. 28-3. 83),hand or arm frequently used at work( OR = 2. 08,95% CI = 1. 14-3. 78) and age( OR = 2. 00,95% CI = 1. 19-3. 35),that were all risk factors of low back pain( P < 0. 05). CONCLUSION: The frequent use of hand or arm at work,insufficient operating space,uncomfortable working posture,feeling tired after work,and long commute time are the main influencing factors affecting the low back pain of automobile manufacturing workers.
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<p><b>OBJECTIVE</b>To observe the effect difference between plum-blossom needle combined with rehabilitation training and conventional rehabilitation training for hand spasm after stroke.</p><p><b>METHODS</b>A total of 61 patients were randomly divided into a comprehensive treatment group (30 cases) and a rehabilitation training group (31 cases). In the rehabilitation training group, Bobath occupational therapy, OT training, and hand function training were adopted, once every day; on the basis of treatment in the rehabilitation group, plum-blossom needle was applied at the lung meridian of hand-, heart meridian of hand-, pericardium meridian of hand- in the comprehensive treatment group. The treatment was given once every two days, three weeks as one course in the two gnoups. After 3 courses of treatment, clinical efficacy evaluation was performed, and the modified Ashworth scale and Fugl-Meyer (FMA) motor function scores were assessed before and after treatment.</p><p><b>RESULTS</b>After treatment, the grade for Ashworth scale and FMA scores in the comprehensive treatment group and the rehabilitation trainning group were better than those before treatment (all <0.05), and the improvements in hand spasm and hand fuction in the comprehensive treatment group were superior apparently to those in the rehabilitation trainning group (both <0.05) The total effective rate of hand function was 93.3% (28/30) in the comprehensive treatment group, which was better than 74.2% (23/31) in the rehabilitation training group (<0.05).</p><p><b>CONCLUSION</b>Plum-blossom needle combined with rehabilitation training are more effective than simple rehabilitation training for hand spasm after stroke.</p>
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Objective:To investigate the clinical application of cognitive behavioral therapy (CBT) and the reasons of the choosing CBT.Method:Totally 14 psychotherapists accepted a semi-structured interview,including their backgrounds of CBT training,the application of CBT in psychotherapy,their attitude toward consultative relations,their opinion on comparing other schools with CBT,and their reasons for choosing CBT.Results:The main reasons for choosing CBT included the influence of important others,the characters of CBT and personal factors.In clinical practice,the most commonly used behavioral techniques included exposure therapy,roll play,relaxation Waining and so on.The most commonly used cognitive techniques included Socratic questioning,cognitive restructuring and challenge unreasonable cognition.Conclusion:Cognitive behavioral therapy (CBT) is suitable for those who are sensible and preferring structural therapy.Nevertheless,the trend in therapy is the integration of different psychotherapy schools.
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OBJECTIVE@#To investigate clinical application of head impulse test with video recording eye movements in the diagnosis of vertigo.@*METHOD@#The video head impulse test(vHIT) was used to measure the eye saccades and velocity gain in 95 patients with vertigo which were divided into two groups, peripheral vertigo (47 cases) and central vertigo(48 cases); the characteristics of eye saccades and velocity gain of six semicircular canals in different patients with vertigo were analyzed, and were compared between the two groups.@*RESULT@#The vHIT result in patients with peripheral vertigo: in 22 patients (23 affected ears) with Meniere's disease, 21 ears were abnormal (91. 3%); the vHIT results in 4 patients with vestibular schwannoma, 2 patients with vestibular neuritis, 5 patients with delayed endolymphatic hydrops, 6 patients with sudden hearing loss accompanied vertigo, and 8 patients with vestibular dysfunction, were abnormal with correct saccades and/or lower velocity gain of vHIT. The abnormal vHIT results were also found in 35 of 48 patients (72. 9%) with central vertigo, which including posterior cerebral circulation ischemia(7 patients), cerebral infarction/stroke(6 patients), and dizziness with vertigo(17 patients) and others(18 patients). Abnormal rate of vHIT in patients with peripheral vertigo was 95. 7% (45/47), which was significantly higher than that (72. 9%) in patients with central vertigo.@*CONCLUSION@#It is easy to perform the vHIT which without adverse reactions. We can record high-frequency characteristics of vestibular-ocular reflex among six semicircular canals through vHIT. The vHIT results which show the function of vestibular ocular reflex in different diseases with vertigo, can help discriminate peripheral vertigo from central vertigo, and it is a practical assessment method for vertigo.
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Humans , Dizziness , Endolymphatic Hydrops , Diagnosis , Head Impulse Test , Meniere Disease , Diagnosis , Neuroma, Acoustic , Diagnosis , Reflex, Vestibulo-Ocular , Saccades , Semicircular Canals , Vertigo , Diagnosis , Vestibular Neuronitis , Diagnosis , Video RecordingABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinical audiological characteristics in Chinese Alport syndrome, and investigate the relationship between the genotypes of Alport syndrome and hearing phenotype.</p><p><b>METHODS</b>The clinical hearing data of 92 cases diagnosed as Alport syndrome from 2008 August to 2013 August were reviewed and analyzed. All coding exons of COL4A3 and COL4A5 genes were PCR-amplified and sequenced from genomic DNA, or mRNA of COL4A5 gene was RT-PCR-amplified and sequenced from skin fibroblast in 17 cases.</p><p><b>RESULTS</b>Eighty-seven out of 92 cases were found with X-linked dominant inheritance (XLAS); 5 cases with autosomal recessive (ARAS); 44 cases had normal hearing, but 14 young cases had abnormal OAE; 48 cases (52.2%, 35 male, 13 female) had sensorineural hearing loss. A total of 44 cases with XLAS had hearing loss (49.4%), wherein the incidence of hearing impairment was 55.0% in male XLAS, and 37.0% in female XLAS. Mild and moderate hearing loss were found in XLAS. Audiometric curves including groove type (21 cases), descending type (13 cases), flat type (10 cases), high frequency drop type (3 cases) and ascending type (1 case) were found in AS. Sixteen mutations of COL4A3, COL4A5 gene were found in 17 cases with Alport syndrome, including severe mutation in 8 cases with moderate hearing impairment.</p><p><b>CONCLUSIONS</b>Mild and moderate hearing impairment, and groove type of audiometric curve are mainly found in Chinese Alport syndrome, which is different from Alport syndrome in western countries. OAE in the early diagnosis of hearing loss is important. Hearing phenotype is related certainly with genotype.</p>