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Objective:This multicenter clinical evaluation analyzed the clinical performance of five fast nucleic acid detection systems for 2019-nCoV.Methods:Clinical performance of the five fast nucleic acid detection reagents approved in China was evaluated in the present study. Fifty-seven throat swabs samples from COVID-19 patients and fifteen throat swabs samples from healthy people were collected from the First Affiliated Hospital of Zhejiang University school of Medicine, Tongji Hospital of Tongji Medical College of HUST, and National Institute of Viral Disease Control and Prevention of CDC to evaluate the positive coincidence rate, negative coincidence rate, total coincidence rate, the detection time and retest rate as well as the relation between positive intensity and positive coincidence rate of the five fast nucleic acid detection systems in November 2020.Results:The positive coincidence rates of the five kits were 92.59% (50/54), 83.64% (46/55), 98.25% (56/57), 94.44% (51/54) and 98.18% (54/55); and the negative coincidence rates were 93.33% (14/15), 93.33% (14/15), 86.67% (13/15), 100% (14/14) and 93.33% (14/15); and the total coincidence rates were 92.75% (64/69), 85.71% (60/70), 95.83% (69/72), 94.20% (65/69) and 97.14% (68/70), respectively. The positive coincidence rate of the five kits reached 100% for the strong-positive (90/90) and medium-positive samples (84/84), but only 82.18% (83/101) for weak-positive samples (cycle threshold value>33), and the retest rate of two kits were 15.28% (11/72) and 12.50% (9/72), which were both higher than 10%. Total time from sample extraction to amplification was between 32.33-65.33 minutes for these five kits.Conclusion:The five fast nucleic acid detection reagents have good performance and can be used as a supplement to routine nucleic acid detection reagents.
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Objective:To establish and evaluate a rapid nucleic acid detection method for SARS-CoV-2 based on COYOTE ? Flash20 real-time fluorescent quantitative PCR instrument. Methods:A rapid reaction system was constructed by using specific primer and probe sets targeting ORF1ab and N gene of SARS-CoV-2, and the sensitivity and specificity of the system were verified. At the same time, 108 clinical samples of COVID-19 were used to evaluate the application of this method.Results:The detection method did not require nucleic acid extraction, and the manual operation time was only one minute. After the sample was sent to the system, the test could be completed in 30 minutes. The detection limit of this method was 4×10 2 copies/ml. It had no cross-reactivity with other human coronaviruses (including HCoV-229E, HCoV-NL63, HCoV-OC43, HCoV-HKU1, SARS-CoV and MERS-CoV) and other respiratory viruses. The evaluation of clinical sample application showed that the total coincidence rate with the conventional RT-qPCR which required nucleic acid extraction was 98.15%. Conclusions:Through the application evaluation of the rapid fluorescent quantitative PCR method of SARS-CoV-2, it was found that the method was simple, fast, specific and sensitive, and it was suitable for real-time and rapid detection needs in varieties of situations.
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Sudden sensorineural hearing loss (SSNHL) refers to the sudden and unexplained sensorineural hearing loss within 72 h and a decrease in hearing of ≥30 dB affecting at least 3 consecutive frequencies. It is one of the common emergencies in neurology and otolaryngology. Early etiological evaluation and systematic and targeted treatment are very important for delaying the progression of SSNHL and restoring hearing. Recent studies have shown that SSNHL overlaps with vascular risk factors of ischemic stroke, and may predict the risk of ischemic stroke. SSNHL may be one of the clinical manifestation and even the prodromal symptoms of ischemic stroke, especially the infarction of the blood supply area of the anterior inferior cerebellar artery or its branch internal auditory artery. Although these factors can not fully reveal the relationship between SSNHL and ischemic stroke, they are enough to warn clinicians that they should consider the possibility of ischemic stroke when receiving patients with SSNHL. Screening of vascular risk factors for patients with SSNHL as early as possible is helpful to avoid the risk of recurrence of ischemic stroke.
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Synaptic dysfunction and abnormal processing of amyloid precursor protein (APP) are early pathological features in Alzheimer's disease (AD). Recently, non-coding RNAs such as microRNAs (miRNAs) and circular RNAs (circRNAs) have been reported to contribute to the pathogenesis of AD. We found an age-dependent elevation of miR-138 in APP/PS1 (presenilin-1) mice. MiR-138 inhibited the expression of ADAM10 [a disintegrin and metalloproteinase domain-containing protein 10], promoted amyloid beta (Aβ) production, and induced synaptic and learning/memory deficits in APP/PS1 mice, while its suppression alleviated the AD-like phenotype in these mice. Overexpression of sirtuin 1 (Sirt1), a target of miR-138, ameliorated the miR-138-induced inhibition of ADAM10 and elevation of Aβ in vitro. The circRNA HDAC9 (circHDAC9) was predicted to contain a miR-138 binding site in several databases. Its expression was inversely correlated with miR-138 in both Aβ-oligomer-treated N2a cells and APP/PS1 mice, and it co-localized with miR-138 in the cytoplasm of N2a cells. CircHDAC9 acted as a miR-138 sponge, decreasing miR-138 expression, and reversing the Sirt1 suppression and excessive Aβ production induced by miR-138 in vitro. Moreover, circHDAC9 was decreased in the serum of both AD patients and individuals with mild cognitive impairment. These results suggest that the circHDAC9/miR-138/Sirt1 pathway mediates synaptic function and APP processing in AD, providing a potential therapeutic target for its treatment.
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Objective To assess the clinical curative effect of accordion technique in the treatment of tibial delayed union or nonunion.Methods From February 2016 to December 2017,data of 11 patients with tibial delayed union (n=8) or non-union (n=3) who had been treated by accordion technique with an Ilizarov ring external fixator were retrospectively analyzed.10 males and 1 female were included in our study,with an average age of 41.9 years (range,21-63 years).There were 5 cases of docking site delayed union after Ilizarov transport for chronic tibial osteomyelitis.There were 3 cases of fracture site delayed union after external fixation for open tibia comminuted fracture.There were 3 cases of nonunion after tibia closed fracture,including 2 cases who had hybrid external fixation treatment,and 1 case who had conservative treatment.All the cases received accordion technique using Ilizarov ring external fixators.First,gradual compression at the fracture site was conducted until the bony contact was seen on a radiograph.After bony contact,compression was continued at a rate of 0.85 mm/d for a week,followed by distraction of 0.85 mm/d for 2-3 weeks.Afterward,a second compression was conducted using same rate and time with the distraction procedure.And there was a 7-day latent period between compression and distraction.One or two cycles of compression-distraction were needed before union was present radiographically.Results Bony union was obtained in all 11 patients after a mean time of 5.4 months (from 3 to 9 months).The mean follow-up for the 11 patients was 15.2 months (from 11 to 29 months).The mean duration of the accordion technique treatment was 50.2 d (range,35-67 d).The accordion technique was used 1 time for 8 patients,and 2 times for 3 patients.The mean duration of bone consolidation was 114.9 d (range,64-239 d).According to Paley evaluation criteria,osseous results were excellent in 8 cases,good in 3 cases,with a good to excellent rate of 100％(11/11);functional results were excellent in 7 cases,and good in 4 cases,with a good to excellent rate of 100％(11/11).Conclusion The accordion technique is a minimal invasive,safe and reliable treatment program for tibial delayed union or nonunion.
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Objective To investigate the relationship between Epstein-Barr virus (EBV) DNA and EBV serology markers and evaluate the clinical application values in different diseases.Methods Plasma samples from 397 diagnosed EBV infection-associated patients and 120 health donors from May 2014 to November 2015 in Wuhan Tongji Hospital were collected.Real-time fluorescent quantitative PCR was performed to detect the levels of EBV-DNA in peripheral blood mononuclear cell and plasma.ELISA was used to detect VCA IgA,VCA IgM,VCA IgG,EA(D) IgG and EBNA IgG antibodies in plasma.The positive rate of EBV-DNA and EBV antibodies were counted in each group according to the detection threshold.Kappa statistic and Spearman sank correlation test were used to analysis the correlation and uniformity between EBV-DNA and EBV serology indicators.Results The positive rate of VCA IgG in patient and health control was 94.2% (374/397) and 93.3% (112/120) respectively (χ2=0.125,P=0.67);The positive rate of EBNA IgG in patient and health control was 95.4% (379/397) and 95.0% (114/120) respectively (χ2=0.045,P=0.807);but the positive rate of VCA IgM was 5.5% (22/397) and 0% (0/120) respectively (χ2=6.9,P<0.01);The positive rate of VCA IgA was 43.3% (172/397) and 9.2% (10/120) respectively (χ2=49.5,P<0.01);The positive rate of EA(D) IgG was 42.0% (167/397) and 7.5% (9/120) respectively (χ2=49,P<0.01).The positive rate of EBV-DNA was 65.5% (260/397) and 16.7% (20/120) respectively (χ2=88.5,P<0.01);The positive rate of EBV-DNA in plasma was 45.8% (182/397) and 5.0% (6/120) respectively (χ2=66.4,P<0.01).Furthermore,the uniformity and Spearman correlation analysis showed that there was no significant correlation between EBV-DNA and EBV serology indicators.The correlation analysis between PBMC EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.073,0.147,0.073,respectively;the correlation analysis between plasma EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.144,0.369,0.288,respectively.Thus,the patients were divided into different groups according to the discharge diagnosis,it was observed that the positive rates of EBV-DNA is more than 90% in extra-nodal NK/T cells lymphoma,EBV-associated hemophagocytic lymphoid tissue hyperplasia,chronic active EBV infection and infectious mononucleosis.In nasopharyngeal carcinoma patients,the positive rate of EBV antibodies (VCA IgA and EA(D) IgG) were higher than the detection of EBV-DNA.Conclusions There was no significant correlation between EBV-DNA and EBV serology markers for the same sample.The clinical application values of EBV DNA and EBV serology markers were not identical in nasopharyngeal carcinoma,extra-nodal NK/T cells lymphoma,infectious mononucleosis and EBV-associated hemophagocytic lymphoid tissue hyperplasia.
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Objective@#To analyze the mutation type of FⅧ gene in children with hemophilia A and to explore the relationship among hemophilia gene mutation spectrum, gene mutation and clinical phenotype.@*Method@#Sixty-two children with hemophilia A from Department of Pediatric Hematology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between January 2015 and March 2017 were enrolled. All patients were male, aged from 4 months to 7 years and F Ⅷ activity ranged 0.2%-11.0%. Fifty cases had severe, 10 cases had moderate and 2 cases had mild hemophilia A. DNA was isolated from peripheral blood in hemophilia A children and the target gene fragment was amplified by PCR, in combination with the second generation sequencing, 22 and 1 introns were detected. Negative cases were detected by the second generation sequencing and results were compared with those of the international FⅧ gene mutation database.@*Result@#There were 20 cases (32%) of intron 22 inversion, 2 cases (3%) of intron 1 inversion, 18 cases (29%) of missense mutation, 5 cases (8%) of nonsense mutation, 7 cases (11%) of deletion mutation, 1 case(2%)of splice site mutation, 2 cases (3%) of large fragment deletion and 1 case of insertion mutation (2%). No mutation was detected in 2 cases (3%), and 4 cases (7%) failed to amplify. The correlation between phenotype and genotype showed that the most common gene mutation in severe hemophilia A was intron 22 inversion (20 cases), accounting for 40% of severe patients, followed by 11 cases of missense mutation (22%). The most common mutation in moderate hemophilia A was missense mutation (6 cases), accounting for 60% of moderate patients.@*Conclusion@#The most frequent mutation type in hemophilia A was intron 22 inversion, followed by missense mutation, again for missing mutation. The relationship between phenotype and genotype: the most frequent gene mutation in severe hemophilia A is intron 22 inversion, followed by missense mutation; the most frequent gene mutation in medium hemophilia A is missense mutation.
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Objective@#To explore the clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer.@*Methods@#We performed a retrospective study of one hundred and eighty mid and low rectal cancer patients who underwent ladder neoadjuvant therapy(neoadjuvant chemotherapy followed by surgery if neoadjuvant chemotherapy was effective; neoadjuvant chemotherapy followed by neoadjuvant chemoradiotherapy if neoadjuvant chemotherapy was ineffective)(n=90) or neoadjuvant chemoradiotherapy (n=90).@*Results@#In the ladder neoadjuvant therapy group, the descent stage rate was 85.6% (77/90), the anastomosis rate was 50.0% (45/90), the pre-sacral infection rate was 4.4% (4/90), the pathological complete remission (pCR) was 13.3%(12/90), R0 resection rate was 85.6% (77/90), the 2-year disease control rate was 76.7% (69/90), and the 2-year survival rate was 90.0% (81/90). In the control group, the descent stage rate was 88.9% (80/90), The anastomosis rate was 45.6% (41/90), the rate of pre-sacral infection was 11.1% (10/90), pCR was 16.7% 15/90), R0 resection rate was 88.9% (80/90), the 2-year disease control rate was 78.9% (71/90), and the 2-year survival rate was 87.8% (79/90). The difference was not statistically significant (P>0.05). The ladder neoadjuvant therapy group had lower prophylactic transverse colostomyrate(10.0% vs 34.4%), lower radiation injury rate (6.7% vs 27.8%), and lower sexual dysfunction rate (38.9% vs 87.8)compared to the control group.@*Conclusions@#The ladder neoadjuvant therapy might reduce side injury caused by radiotherapy, improve compliance of patients, and reduce treatment costs. Moreover, the RO resection rate, 2-year local control rate and 2-year survival rate of ladder neoadjuvant therapy group was comparable with neoadjuvant chemoradiotherapy.
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<p><b>OBJECTIVE</b>To observe the proportion change of immune cells in the peripheral blood of patients with rectal cancer after neoadjuvant therapy and to explore the relationship between tumor regression and CD4⁺CD25(High)CD127(low) regularly T cells(Treg cells).</p><p><b>METHODS</b>Patients with rectal cancer who underwent the neoadjuvant therapy before surgery at the Shanxi Cancer Hospital Colorectal Surgery Department from January to December 2013 were prospectively enrolled. These patients were divided into down-staging group and non-down-staging group according to the change of staging in accordance with TNM classification for rectal cancer after neoadjuvant therapy. Flow cytometry was used to analyze the proportions of Treg cells, CD4+T cells, CD8+T cells, NK cells, B cells, and CD4+/CD8+ ratio in the peripheral blood from these patients before and after neoadjuvant therapy.</p><p><b>RESULTS</b>A total of 108 patients were enrolled, including 76 cases in the down staging group and 32 cases in the non-down-staging group. Differences of immune cells proportions between two groups before neoadjuvant therapy were not statistically significant(all P>0.05). In the down-staging group, the proportions of Treg cells, B cells and CD4+/CD8+ ratio were decreased while the proportion of NK cells did not change obviously after the neoadjuvant therapy. Interestingly, in the non-down-staging group, the proportions of B cells and CD4+/CD8+ ratio were decreased while the proportions of Treg cells and NK cells did not change obviously after the neoadjuvant therapy. In addition, after neoadjunvat therapy, the proportion of Treg cells in down-staging group was significantly lower than that in non-down-staging group [(4.4 ± 1.7)% vs. (6.2 ± 1.9)%, P=0.001].</p><p><b>CONCLUSION</b>For patients in the down-staging group after neoadjuvant therapy, the proportion of Treg cells in peripheral blood decreases, suggesting that Treg cells may be a valuable biomarker for assessing tumor regression.</p>
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Humans , CD4-CD8 Ratio , Flow Cytometry , Interleukin-2 Receptor alpha Subunit , Interleukin-7 Receptor alpha Subunit , Killer Cells, Natural , Neoadjuvant Therapy , Rectal Neoplasms , T-Lymphocytes, Regulatory , Treatment OutcomeABSTRACT
ObjectivesTo compare clinical outcomes and safety of 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer. MethodsLiterature search were performed by key words,such as metastatic colorectal cancer,capecitabine,oxaliplatin,5-Fu on all randomized controlled trails reported on 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer before Jun.2011.Two authors drew the details of trail design,characteristics of patients,outcomes and so on from the studies included. Data analysis was performed by RevMan 4.2. ResultsAccording to the same screening criteria,6 clinical studies were included in this Meta-analysis. Sample volume in this Meta-analysis was 2189 colorectal cancer cases.The baseline characteristics of 5-Fu group were similar to those of capecitabine group.The short-term outcome such as response rate,RR was 0.92 [95 ％CI(0.82,1.02),P=0.12], and the long-term outcome such as median overall survival, median progression-free survival and the WMD was -0.19 [95 ％CI(-0.73,0.35),P=0.49],-1.91 [95 ％CI(-2.53,0.16),P=0.08],respectively,two groups weresimilar. In the comparison of Ⅲ-Ⅳ grade toxicity between the two groups, the incidences of neutropenic in 5-Fu group were higher than those in capecitabine group,and the RR was 0.24 [95 ％CI(0.11,0.55), P=0.0007]. However, the incidence of wand-foot symptoms in 5-Fu group was lower than those in capecitabine group, the RR was 2.83 [95％CI (1.66,4.82), P=0.0001]. ConclusionBoth 5-Fu and capecitabine were similarly effective in the therapy of metastatic colorectal cancer. And the Ⅲ-Ⅳ grade toxicity such as neutropenic was easier to happen in 5-Fu group,while the incidence of hand-foot symptoms was on the other hand.
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ObjectiveTo explore the clinical significance of lymph node metastasis in gastrointestinal stromal tumor (GIST).Methods A literature search to identify studies relating to GIST cases reported between January 1998 and December 2010 was conducted.The associations between lymph node metastasis and GIST clinicopathological features, gene expression, GIST stage, and GIST prognosis were evaluated.Results 6063 literatures were screened and only 16 GIST patients (median age of 49.25 years,10females) with lymph node metastasis were enrolled in this study.Among them,12 tumors were located in the stomach, 3 in the small intestine, and 1 in the esophagus.Morphologically, 13 specimens were mainly characterized by spindle cells.Gene analysis was examined in 7 cases.Conclusions Lymph node metastasis in GIST might more frequently found in the stomach, tumor stage of high grade, and cellular morphology of spindle-shaped.Gene mutation may have a relationship with lymph node metastasis.However, its clinical significance remains unclear.
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Incidence of cancer is increasing year by year,diagnostic techniques are continually advanced,and the numbers of anti-cancer drugs are growing,but the efficacy has not been fundamentally improved.Surgery,chemotherapy and radiotherapy can only kill the part of mature tumor cells,but can not kill the cancer stem cells,and eventually leading to tumor recurrence.While acupuncture,qigong,psychology comprehensive treatment can inhibit tumor growth and reduce metastasis and recurrence,improve quality of life and prolong survival.We should update our recognition,to carry out the study on the treatment of tumor by TCM with large sample and multiple centers,to demonstrate its low toxicity,low costs and efficiency.
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Objectives: To find out the current situation of the reproductive and the mental health about the countrywomen in the northwest of China,and explore the influence of the reproductive and the mental health under the biological,psychological and social factor.Methods: Self-rating depression scale(SDS)and Self-rating anxiety scale(SAS) and life event scale(LES) have been used,and do 608 samples survey in Xi'an of Shaanxi about their reproductive and the mental health.Results: The research clarified that 25.3% of the countrywomen are in anxious mood and 35.0% of them are in depressed mood.The main factors that influence them are economic,marriage and family problems.Conclusion: The current situation of the psychological health about the countrywomen is worth concerning.While doing work to pretect the women health,pay attention to the mental needs of women and the characteristics of their psychological problems and change the protecting ways in time.
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Objective: to measure anxiety status and explore integrated factors about anxiety of countrywomen in Shaanxi, then put forward to suggestions for improving women's mental health under the bio - psycho - social medical model. Methods: A cross - sectional survey was adopted. 592 married countrywomen volunteers were selected by cluster random sampling from Chang'an district of Xi'an in Shaanxi province. Self - rating anxiety scale, Self - rating depression scale and Life events scale were used for assessment of mental health of the subjects. Additional, gynecologic examinations were done to measure personal reproductive health status. Results: The facts of mental status of Shaanxi rural women brook no optimism. Among the 592 samples that were investigated in current study, 25. 3% have anxiety symptoms. For the study population, the average total index score of SAS was 34. 34. Further analysis revealed that dysmenorrhea, menarche age and depression are main risk factors influencing women's anxiety status. In addition, married countrywomen's anxiety is related to sexual intercourse satisfaction, uterus motion and per capita health care spending, etc.
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Objective: To find out the current situation of the reproductive health about countrywomen in west of China,and explore the factor of the reproductive health under social medicine theory framework.Methods: Summarize literature about women reproductive which have been done recently,and do 608 samples survey in Xi'an of Shaanxi,which is about the current situations of social economic,reproductive health,gynecological diseases and mental health.Results: The research clarified the primary connotation about the reproductive health of countrywomen,and identified the current situation of countrywomen reproductive health in Shaanxi province of China.Conclusion: The situation of countrywomen reproductive health is far away from the demand of strategic target of "Everyone enjoys the reproductive care since 2015",and the countrywomen are on the hip in birth control,bearing culture,acquirement of health knowledge and primary diathesis.
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The new general photography system is composed of overhang of SX-YB2 departed from the mainframe of HITACHI Digital Fluoroscpic(model 110XF),topmanagement system of FSK302-1 and FSB302-1 and leveled adiogaphy system of F78-III.The filament heater circuit,rotating anode startup and running circui and X-ray produce circuit are mainly changed,and some circuits in power and filament heat are added.