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Objective:To explore the value of conventional ultrasonography combined with cervical compression in the diagnosis of orbital venous malformation (OVM).Methods:A total of 43 patients with suspected OVM were admitted in sequentially from January 2019 to July 2022 in the Third Medical Center of PLA General Hospital. All patients were examined by ultrasonography combined with cervical compression and demonstrated by operation or digital subtraction angiography (DSA). The conventional ultrasound features of OVM were summarized, and the value of conventional ultrasonography combined with cervical compression in the diagnosis of OVM was discussed.Results:The features of the conventional ultrasound combined with cervical compression for diagnosis of OVM were as follows: the interior of lesion was mainly tubular structure, and the compression test was positive. After cervical compression, the lesion enlarged and the inner diameter of the internal tubular structure widened. Doppler flow imaging showed that the interior of lesion was mainly venous blood flow. Compared with the results of postoperative pathology or DSA, the sensitivity, specificity, accuracy and positive predictive value of ultrasonography combined with cervical compression were 0.952, 1.000, 95.3% and 100%, respectively. The results of Fisher exact diagnosis showed that there was no significant difference between ultrasonography and operation or DSA of OVM( P>0.05). Conclusions:Conventional ultrasound combined with cervical compression can be used as an effective method for the diagnosis of OVM.
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Objective:To evaluate the diagnostic efficiency of hypersensitivity quantitative fecal immunochemical test (hs-qFIT) in colorectal cancer (CRC) and advanced adenoma.Methods:From July to December 2020, consecutive patients aged 50 to 75 years who underwent colonoscopy in Qilu Hospital of Shandong University, and had the Asia-Pacific colorectal screening score of medium or high risk were enrolled. All patients were requested to complete two hs-qFIT before colonoscopy. The diagnostic efficacy of hs-qFIT for CRC and advanced adenoma were assessed. Receiver operating characteristic curve of hs-qFIT in CRC diagnosis was drawn and the area under the curve (AUC) was calculated.Results:A total of 811 patients including 20 (2.5%) cases of CRC, 47 (5.8%) cases of advanced adenoma, 206 (25.4%) cases of non-advanced adenoma, 219 (27.0%) cases of non-adenomatous polyp, 76 (9.4%) cases of other colorectal lesions and 243 (30.0%) cases of non-colorectal lesions were involved. When the fecal hemoglobin cut-off values were 10, 30, 50, 75 and 100 ng/mL, the positive rates of hs-qFIT detection were 17.9% (145/811), 10.9% (88/811), 8.3% (67/811), 7.4% (60/811) and 5.8% (47/811), respectively. When the cut-off value of fecal hemoglobin decreased from 100 ng/mL to 10 ng/mL, the sensitivity of hs-qFIT for CRC diagnosis increased from 90.0% to 100.0%, and the specificity decreased from 96.3% to 84.2%; and the sensitivity of hs-qFIT for the diagnosis of advanced adenoma increased from 19.1% to 66.0%, and the specificity decreased from 95.0% to 85.1%. The AUC of hs-qFIT for the diagnosis of CRC and advanced adenoma were 0.981 (95% confidence interval ( CI) 0.970 to 0.992) and 0.846 (95% CI 0.807 to 0.886), respectively. When the optimal cut-off values were taken, the sensitivity and specificity were 100.0% and 91.2% for the diagnosis of CRC, and 66.0% and 85.3% for the diagnosis of advanced adenoma, respectively. Conclusion:Hs-qFIT can help the early screening of CRC and advanced adenoma.
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The role of skin microbiota in the occurrence of rosacea remains unclear. This review summarizes several important skin microorganisms that have been reported to be possibly related to the occurrence of rosacea, including Demodex, Bacillus oleronius, Propionibacterium acnes, Corynebacterium kroppenstedtii, etc., and further elaborates on the potential mechanisms of action.
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Objective To provide reference for anti-infection treatment and individual pharmaceutical care in patient on peritoneal dialysis. Methods The plasma concentration of vancomycin in patient on peritoneal dialysis was monitored by clinical pharmacists. The anti-infection treatment plan was evaluated and adjusted according to the bacterial culture and drug sensitivity results of the abdominal dialysis fluid. The adverse reactions of pancytopenia induced by vancomycin were documented. Results Infection in the patient on peritoneal dialysis was effectively controlled. The related indicators of pancytopenia were improved. Conclusion A case of pancytopenia induced by vancomycin in the patient on peritoneal dialysis was analyzed to get clinical staff's attention to this adverse reaction and improve the safety of vancomycin administration.
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Objective:To investigate the correlation between white matter hyperintensities (WMHs) and stroke etiology classification in patients with acute isolated penetrating artery territory infarction.Methods:Patients with first-ever acute isolated penetrating artery territory infarction admitted to the Department of Neurology, the Affiliated Hospital of Xuzhou Medical University from January 2017 to May 2020 were enrolled retrospectively. According to the Chinese Ischemic Stroke Subclassification (CISS) system, they were divided into large artery atherosclerosis (LAA) and perforating artery disease (PAD). According to the distribution of infarcts, they were divided into lenticulostriate artery (LSA) territory infarction and paramedian pontine artery (PPA) territory infarction. The demographics, vascular risk factors, baseline clinical data, WMHs location, and Fazekas Scale scores were documented. Multivariate logistic regression analysis was used to identify the independent influencing factors of stroke etiology classification. Results:A total of 440 patients with acute isolated penetrating artery territory infarction were enrolled, including 120 (27.3%) in the LAA group, and 320 (72.7%) in the PAD group; 213 (48.4%) with LSA territory infarction, and 227 (51.6%) with PPA territory infarction. The proportion of patients with total Fazekas score 3-6 and periventricular WMHs (PWMHs) score 2-3 in the PAD group was significantly higher than those in the LAA group (all P<0.05). In patients with LSA territory infarction, the proportion of the patients with hypertension, WMHs total Fazekas score 3-6 and PWMHs score 2-3 in PAD subgroup was significantly higher than those in the LAA subgroup, while the proportion of the patients with hyperlipidemia was significantly lower than that in LAA subgroup (all P<0.05). In patients with PPA territory infarction, the levels of low-density lipoprotein cholesterol and homocysteine in the PAD subgroup were significantly lower than those in the LAA subgroup. Multivariate logistic regression analysis showed that PWMHs score 2-3 was an independent correlation factor of PAD (odds ratio [ OR] 2.220, 95% confidence interval [ CI] 1.085-4.541; P=0.029). In patients with LSA territory infarction, hyperlipidemia was independently correlated with LAA ( OR 0.432, 95% CI 0.192-0.972; P=0.042), and PWMHs score 2-3 was independently correlated with PAD ( OR 3.846, 95% CI 1.193-12.397; P=0.024). In patients with PPA territory infarction, higher low-density lipoprotein cholesterol ( OR 0.660, 95% CI 0.494-0.883; P=0.005), homocysteine ( OR 0.958, 95% CI 0.930-0.987; P=0.005) and C-reactive protein ( OR 0.987, 95% CI 0.977-0.997; P=0.008) were independently correlated with LAA. Conclusions:WMHs are common in patients with acute isolated perforating territory infarction caused by LAA and PAD, and more severe PWMHs suggest that PAD is more likely to be the cause of the acute isolated perforating territory infarction, especially in patients with LSA territory infarction.
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Objective To investigate CT features of multifoeal lung adenocarcinoma (MLA) with ground glass opacity and the relationships with pathology.Methods Totally 16 cases (36 lesions) of MLA confirmed by pathology were collected.Based on pathology,the lesions were divided into pre-invasive lesion group (n =7),minimally invasive adenocarcinoma (MIA) group (n=20) and invasive adenocarcinoma (IAC) group (n =9).CT features of all three groups were analyzed and compared with pathology.Results Among 36 lesions,there were 19 lesions (52.78％) with round shape,19 (52.78％) with lobulation,12 (33.33％) with spiculation sign,13 (36.11％) with vacuole sign,12 (33.33％)with blood vessel cluster sign,and 32 lesions (88.89％) with well-defined interface.Seven pre-invasive lesions (7/7,100％) were all pure ground glass opacity (pGGO),while 12 lesions (12/20,60.00％) were pGGO in MIA group,other 8 lesions (8/20,40.00％) were mixed ground glass opacity (mGGO).Only 1 lesion (1/9,11.11％) in IAC group was pGGO,other 8 lesions (1/9,88.89％) were mGGO.There were significant differences of pGGO,spiculation sign,vacuole sign and blood vessel cluster sign among 3 groups (all P＜0.05).There were significant differences of pGGO,spiculation sign and blood vessel cluster sign between pre-invasive lesion and IAC group (P=0.001,0.003,0.001).Significant differences were found in spiculation sign,vacuole sign and blood vessel cluster sign between MIA and IAC group (P=0.014,0.014,0.001).Conclusion CT findings of multiple ground glass opacity are helpful to diagnosis of MLA before surgery.
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Objective To investigate the diagnostic value of CT thin-section target reconstruction technique in patients with pulmonary small size groud glass nodules (sGGN).Methods A total of 109 patients with pulmonary sGGN certified post-operation and/or follow up were analyzed retrospectively,and the clinical and CT images of all patients were completely collected.There were 23 cases of benign group,21 cases of adenocarcinoma in situ group,29 cases of minimally invasive adenocarcinoma group and 36 cases of invasive adenocarcinoma group,respectively.The differential diagnostic value using CT thin-section target reconstruction technique was analyzed between the benign and malignant pulmonary sGGN groups,and the CT feature detection rates were compared between CT thin section target and common reconstruction techniques.Results The CT thin-section target reconstruction technique had improved the diagnostic efficiency of pulmonary sGGN.The diagnostic accuracy,area under curve(AUC),sensitivity and specificity were 85.32 ％,0.679,90.80 ％,63.64 ％ in malignant group and 77.06％,0.764,83.72％,52.17％ in benign pulmonary sGGN group,respectively.The CT features as solid component in whole nodule,"halo sign",speculation sign,pleural retraction sign,lobulation sign were more detected by using the thin-section target reconstruction technique than that by using the common reconstruction among adenocarcinoma in situ group,minimally invasive adenocarcinoma group and invasive adenocarcinoma group (P＜0.05) but not speculation sign in the invasive adenocarcinoma group(P=0.126).Conclusion The CT thin section target reconstruction technique can improve the diagnostic value of pulmonary sGGN.
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Objective To find out the main pathogenic bacteria distribution and sensitivity to antibiotics in patients post PTCD for malignant biliary obstruction ,to evaluate the therapeutic effectiveness of antibiotics and provide evidences for rational use of antibiotics .Methods The clinical data were collected and analyzed retrospectively from 423 PTCD cases with malignant biliary obstruction from September 2013 to October 2014 .Results Among 423 patients underwent PTCD ,101 patients were confirmed with infections .67 patients showed positive pathogenic bacteria culture .A total of 94 strains of pathogenic bacteria were detected .There were 62 strains of gram negative bacteria (65 .96% ) and 32 strains of gram positive bacteria (34 .04% ) . The main pathogenic bacteria were klebsiella pneumoniae , Escherichia coli ,enterococcus faecalis and Enterobacter cloacae . Klebsiella pneumoniae and Escherichia coli are the two gram negative bacteria most resistant to antibiotics .The three popular gram negative bacilli in this study had the lowest resistance to imipenem/cilastatin ,piperacillin/tazobactam and amikacin .The three main gram positive bacteria were most sensitive to daptomycin ,linezolid and vancomycin .The total effective rate of anti-biotic treatments for post PTCD infections was 88 .1% .Conclusion Our hospital had an appropriate treatment plan with antibi-otics to control the infections post percutaneous transhepatic cholangio-drainage for malignant biliary obstruction .According to the results of drug sensitivity test ,ceftriaxone had high resistance rate .The outcome with ceftriaxone treatment was unsatis-factory .Clinical pharmacists should advise doctors to reduce the usage of ceftriaxone .Glycopeptide antibiotics can be used to control methicillin-resistant staphylococcus (MRS) gram positive bacteria .
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Objective To assess the use of human albumin (ALB) after hepatectomy in hepatocellular carcinoma patients in our hospital .Methods 150 hospital medical records from June 2012 to June 2013 were analyzed ,which used the human ser-um albumin during the perioperative period of hepatectomy at hepatocellular carcinoma (preoperative Child-Pugh A or B) retro-spectively ,the rationality of human blood albumin use was evaluated .Results Among the 150 medical records ,the total appli-cation amount of albumin was 11 212 .5 g (897 bottles) ,the total cost was 527 ,744 yuan ,nearly 20 percent of total drug costs ,accounting for nearly 10% of the total cost of hospitalization .By using human serum albumin after surgery ,the patients'liver function was significantly improved (P<0 .05) ,there was a positive correlation between the Child-Pugh score and dosage of human albumin (P<0 .05) .Conclusion The use of human serum albumin was rational during the perioperative period of hepatectomy in hepatocellular carcinoma patients in our hospital ,which had achieved the desired therapeutic effect .
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Objective To analyze the CYP2C19 genetic polymorphisms in patients suffering from gastric diseases in Beijing and Shandong, and to evaluate the possibility of using the same gastric biopsy samples for the isolation of Helicobacter pylori ( H.pylori) strains.Methods A total of 1649 gastric biopsy samples positive for rapid urease test ( RUT) were collected from patients with gastric diseases in Beijing and Shandong.Each sample was grinded and equally divided into two parts for the isolation of H.pylori strains and the analysis of CYP2C19 genetic polymorphisms, respectively.H.pylori strains were isolated from the samples and identified with catalase and urease.CYP2C19*2 and CYP2C19*3 specific primers were used for the PCR amplification of DNA extracts.The PCR products were analyzed by electrophoresis and nucleo-tide sequencing.The metabolic types of CYP2C19 were analyzed based on the results of nucleotide sequen-cing.Results Altogether 1415 (85.81%) H.pylori strains were isolated successfully from the 1649 gastric biopsy samples.The products of CYP2C19 specific PCR for all DNA extracts showed clear bands in electro-phoresis and were further confirmed with sequencing analysis.Statistical analysis revealed that there were no statistical differences with the percentages of CYP2C19 metabolic types between Beijing and Shandong, nor between males and females (P>0.05).Conclusion It showed the possibility of using the same gastric bi-opsy samples for the isolation of H.pylori strains and the analysis of CYP2C19 genetic polymorphisms.No significant differences with the percentages of CYP2C19 metabolic types were found between patients from Beijing and Shandong.
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Steroid hormones were chemical compounds of high efficiency , which played a significant role in various physiologi-cal activities.However, the concentrations of hormones in vivo were extremely low, so it was very important for their accurate quantifi-cation.Chromatography-mass spectrometry technology was widely employed because of advances in high efficient , rapid and sensitive. The application of steroid hormone analysis by chromatography-mass spectrometry was reviewed in this paper , which could provide ref-erence for furthuer clinical research .
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Objective To study the common influenza viruses infection of hospitalized patients admitted for acute respiratory tract infections, using gold immunchromatographic assay ( GICA ) to detect influenza viruses. Methods The result of FluA/B antigen detection in 1145 patients with various types of respiratory diseases from two class-A hospitals were analyzed. Influenza virus detection rates of patients in different seasons,with different gender,age,types of respiratory diseases and whether with foundation diseases were analyzed to identify the common rules and characteristics. Results There were significant differences for Flu A/b detection rate between first quarter and the second or third quarter,P <0.05 by x2 test( FluA x2 = 17. 735, P = 0.000;X2 = 14.855,P = 0. 000;FluB x2 =5. 326,P = 0. 021;x2 = 4.349, P = 0.037 ) . The result was repeated in the comparison between Flu A/B detection rate in the fourth quarter and the second or third quarter,P <0. 05 by x2 test (FluA x2 =19. 480,P= 0.000;x2 =16.771,,P=0. 000;FluB X2 = 6. 885.P = 0. 009;x2 =5. 959,P =0.015). These results indicated the detection rates of the first and fourth quarter were higher than the second and third quarter. Elderly patients (≥65 years old) had higher Flu A/ B detection rate compared with patients below 65 years ( FluA x2 =55. 362,P = 0.000;FluB x2 = 8.984,P = 0.003). The detection rate of Flu A/B in patients without foundation diseases or with one,two or three kinds of foundation diseases had significant differences, which showed with an increase in the number of types of the foundation diseases, FluA/B-positive detection rate increased. In patients with various foundation diseases, the FluA antigen detection rate in group of AECOPD patients was 18.2% and 17.1% in pneumonia group, which were higher than in all other diseases. Conclusions Sporadic cases of influenza were found in general wards, incidence rate was higher in the first and the fourth quarter. There is a higher risk of influenza virus infection for elder patients and patients with foundation diseases.
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Objective To compare the effectiveness of different methods of collecting nasopharyngeal secre-tions by nasopharynx swab and nasopharyngeal underpressure suction catheter for rapid detection of influenza virus. Methods Nasopharyngeal secretions as the experimental samples of 1042 patients with acute respiratory tract disea-ses were collected by nasopharynx swab and nasopharyngeal suction catheter, and gold immunochromatographic assay (GICA) kit was applied for the detection of influenza viruses. Results The use of the above two methods collecting nasopharyngeal secretions as samples for rapid detection of influenza virus would get the same results. The difference between the two methods had no statistical significance( P > 0.05 ). Conclnsions Nasopharynx swab is a reliable method for rapid detection of influenza virus, which is fast and convenient, compared with nasopharyngeal suction catheter.