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1.
Article in Chinese | WPRIM | ID: wpr-932409

ABSTRACT

Objective:To evaluate the ability of vascular endothelial growth factor receptor 2(VEGFR2)/integrin α vβ 3 dual-targeted microubble (MBD) to target angiogenesis of renal cell carcinoma (RCC) in vivo. Methods:Non-targeted microbubble (MBN) USphere LA was employed as a template to prepare single- and dual-targeted microbubbles which could bind VEGFR2 and/or integrin α vβ 3 (MBV and MBI) by the biotin-avidin bridging method. A total of 40 RCC nude mice models were established by subcutaneously injecting 786-O cells.Twenty of the models were all injected with MBN, MBV, MBI and MBD in a random order, and the other 20 models were registered for antibody blocking assays. The results of ultrasound images were used for quantitative analyses, and the following quantitative parameters were obtained: intensity increment (a 1), peak halving speed (a 2), curve rising slope (a 3), perfusion time (t 0), time to peak (TTP), peak intensity (PI), mean transit time (MTT) and area under the curve (AUC) for the first three minutes, peak intensity at 10 s before (P 1) and after (P 2) ultrasound destruction, and the differences of tissue enhancement (dTE) between P 1 and P 2 (dTE=P 1-P 2). All the quantitative parameters of four contrast agents and the antibody blocking assays were compared.Besides, the immunohistochemical assays were performed to evaluate the expression of CD31, VEGFR2 and integrin α vβ 3 in tumor tissues. Results:The differences of parameters of a 1, a 3, t 0, TTP, PI and P 2 among four different microbubbles had no statistical significances (all P>0.05), and all parameters between the two single-targeted contrast agents were not statistically different (all P>0.05). The parameters of AUC, MTT, P 1 and dTE all showed a trend that dual-targeted bubbles > single-targeted bubbles > non-targeted bubbles (all P<0.05). On the contrary, the trend of dual-targeted bubbles < single-targeted bubbles < non-targeted bubbles (all P<0.05) was observed for a 2. In the antibody blocking experiment, a 2 was faster after the antibody injection ( P<0.001), while AUC, MTT, P 1 and dTE were all lower than those before the antibody injection ( P<0.001), and the other parameters were not statistically different before and after the antibody injection (all P>0.05). Immunohistochemical analyses confirmed the high expression of CD31, VEGFR2 and integrin β 3 in tumor tissues. Conclusions:The VEGFR2 and integrin α vβ 3 dual-targeted microbubble has a good potential to target the angiogenesis of human RCC in vivo.

2.
Article in Chinese | WPRIM | ID: wpr-881250

ABSTRACT

@#Objective    To investigate the efficacy of uniportal video-assisted thoracoscopic surgery (VATS) anatomic basal segmentectomy. Methods    The clinical data of 15 patients who underwent uniportal VATS anatomic basal segmentectomy between June 2020 and December 2020 were retrospectively reviewed. There were 4 males and 11 females with a median age of 53 (32-70) years. The incisions were placed in the fifth intercostal space across the mid-axillary line. All basal segmentectomies were performed through the interlobar fissure or inferior pulmonary ligament approach following the strategies of single-direction and stem-branch. Results    All patients underwent basal segmentectomy successfully with no conversion to multi-portal procedure or thoracotomy. The median operation time was 120 (90-160) min, median intraoperative blood loss was 20 (10-50) mL, median drainage time was 3 (2-5) d, and median postoperative hospital stay was 4 (4-10) d. The maximum diameter of the lesion in the resected basal segment was 1.2 (0.7-1.9) cm. The median resected lymph nodes were 7 (5-12). There was no evidence of nodal metastases. One patient suffered postoperative atelectasis and subsequent pneumonia. No perioperative death occurred. Conclusion    Uniportal VATS anatomic basal segmentectomy is feasible and safe. It can be performed in a simple manner following the strategy of single-direction.

3.
Article in Chinese | WPRIM | ID: wpr-910140

ABSTRACT

Objective:To investigate the clinical feasibility of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the quantitative assessment of blood perfusion of hepatocellular carcinoma (HCC).Methods:Between January 2020 and August 2021, 36 HCC patients (39 lesions in total) confirmed by pathology and clinical diagnosis without any treatment from Zhongshan Hospital, Fudan University were enrolled and underwent both 2D-CEUS and 3D-CEUS examinations. Each examination last for 150 s and all images were recorded, and then the data were analyzed. A region of interest was manually drawn along the margin of the whole tumor and then the time-intensity curve (TIC) generated. The following perfusion parameters were extracted: peak intensity (PI), peak time (TTP), ascending slope (AS), mean transit time (MTT) and area under the curve (AUC). After calculating the quality of fit (QOF) of the curve, the intraobserver agreement of the 3D-CEUS quantitative parameters obtained by the same doctor between two times were assessed, and the consistency of the 3D-CEUS and 2D-CEUS quantitative parameters was evaluated when QOF>75%. The differences of the quantitative parameters between different groups (divided by depth of 8 cm and necrosis rate of 50%, respectively) in 3D-CEUS were compared.Results:There were 38 lesions (97.4%, 38/39) with QOF>75% in 3D-CEUS. The intraobserver agreement was excellent, the intraclass correlation efficient(ICC) values was 0.85-0.99. The consistency of the time quantitative parameters (TTP and MTT) were high (the ICC values of 0.87 and 0.91), and the correlation of intensity quantitative parameters were substantial, the rs values were 0.71, 0.72 and 0.71. The differences in 3D-CEUS quantitative parameters of the two groups of lesions with different depths were statistically significant (all P<0.05); but there were no significant differences in quantitative parameters between the two groups with different necrosis rate (all P>0.05). Conclusions:Quantitative 3D-CEUS is an useful and creditable tool in evaluating the blood perfusion of HCC, especially when the depth of lesion was less than 8 cm.

4.
Article in Chinese | WPRIM | ID: wpr-910132

ABSTRACT

Objective:To explore the diagnostic performance of ultrasound attenuation imaging (ATI) in grading the degree of hepatic steatosis in metabolic dysfunction-associated fatty liver disease (MAFLD).Methods:The liver gray-scale ultrasound and ATI examinations were performed on 212 subjects who were treated in Zhongshan Hospital Affiliated to Fudan University from August 2020 to March 2021. The attenuation coefficient(AC) values among different degrees of hepatic steatosis were analyzed and the diagnostic performance of ATI was evaluated. Relationships between AC values and clinical characteristics were assessed by Pearson′s correlation analysis.Results:The AC values for normal liver, mild, moderate and severe fatty liver were (0.56±0.05)dB·cm -1·MHz -1, (0.68±0.09)dB·cm -1·MHz -1, (0.82±0.09)dB·cm -1·MHz -1, (0.94±0.09)dB·cm -1·MHz -1, respectively. There were significant differences in AC values among different hepatic steatosis divisions( P<0.008). There was highly significant correlation between AC values and the degree of hepatic steatosis( r=0.860, P<0.01), moderate correlation between AC values and BMI( r=0.425, P<0.01), weak correlation between AC values and HDL-C( r=-0.237, P=0.029), no correlations between AC values and age, TC, TG, LDL-C ( r=0.083, 0.055, 0.133, -0.039, all P>0.05) .The areas under the receiver operating characteristics curve of ATI for mild fatty liver and above, moderate fatty liver and above, severe fatty liver and above were 0.958, 0.962, 0.918; the sensitivity were 90.1%, 95.8%, 94.9%, the specificity were 96.1%, 87.1%, 73.9%, and the cut-off values were 0.666 dB·cm -1·MHz -1, 0.719 dB·cm -1·MHz -1, 0.803 dB·cm -1·MHz -1, respectively. Conclusions:ATI is a reliable and convenient method for evaluating the degree of hepatic steatosis in MAFLD.

5.
Article in Chinese | WPRIM | ID: wpr-886852

ABSTRACT

@#Objective    To analyze the results and diagnostic value of postoperative chylous test of pleural effusion and to verify the clinicopathological factors affecting the results of chylous test. Methods    The clinical data of 265 consecutive patients undergoing selective surgery at the Department of Thoracic Surgery, Shangjin Nanfu Hospital between May and August 2020 were retrospectively analyzed, including 106 males and 159 females with an average age of 53.0±12.2 years. According to the results of the chylous test on the operation day and postoperative first and second days, the patients were divided into two subgroups, including a positive group and a negative group, and the clinical data of the two groups were compared. Sensitivity and specificity of the chylous test were calculated. The influencing factors for chylous test were analyzed by multiple logistic regression analysis. Results    The positive rate of chylous test was 91.7%, 95.8% and 87.9% on the operation day and postoperative first and second days, respectively. There was no statistical difference in age, sex, surgical type, surgical approach, surgical site, surgical time, degree of lymph node dissection, treatment of thoracic duct, 24 hours pleural fluid drainage or 24 hours protein and fat food intake between the positive group and the negative group (P>0.05). The diagnostic sensitivity and specificity of the chylous experiment were 100.0%and 4.0%, respectively. Multiple logistic regression analysis showed that the surgical site (left/right chest) might be an influencing factor for the results of the chylous test (P=0.043, OR=0.458, 95%CI 0.216-0.974). Conclusion    The positive rate of chylous test of pleural effusion after thoracic surgery is very high. The chylous test produces a high misdiagnosis rate of chylothorax. The surgical site (left/right chest) may be an influencing factor for chylous test. The positive result of chylous test is not recommended as the direct diagnostic basis for postoperative chylothorax and guidance of the subsequent treatment.

6.
Article in Chinese | WPRIM | ID: wpr-886544

ABSTRACT

@#Objective    To explore the safety and feasibility of the modified and improved thoracoscopic surgery for esophageal cancer using the concept of "single-direction" thoracoscopic technique. Methods    The clinical data of 65 patients undergoing this modified minimally invasive esophagectomy based on "single-direction" thoracoscopic system between June 2018 and April 2019 were retrospectively analyzed, including 54 males and 11 females aged 62.5±7.8 years. Results    The thoracoscopic operation time was 133.4±28.6 min, and intraoperative blood loss was 61.9±29.2 mL. No intraoperative blood transfusion was needed. One patient was transferred to open thoracotomy (due to severe pleural adhesion atresia). Major complications included anastomotic leak, pneumonia, chylothorax, incisional infection, recurrent laryngeal nerve paralysis and gastric emptying disorders, which were recovered by conservative treatment. No postoperative death occurred. The median number of lymph nodes and lymph node station harvested was 19 and 10, respectively. The median postoperative hospital stay was 10 days. The volume of chest drainage was 1 117.3±543.4 mL. Conclusion    The minimally invasive operation mode of esophageal cancer based on "single-direction" thoracoscopic system is safe and feasible, and has good field vision and smooth and simplified procedure.

7.
Article in Chinese | WPRIM | ID: wpr-886507

ABSTRACT

@#Objective    To analyze the operation outcomes and learning curve of uniportal video-assisted thoracoscopic surgery (VATS). Methods    All consecutive patients who underwent uniportal VATS between November 2018 and December 2020 in Shangjin Branch of West China Hospital of Sichuan University were retrospectively enrolled, including 62 males and 86 females with a mean age of 50.1±13.4 years. Operations included lobectomy, segmentectomy, wedge resection, mediastinal mass resection and hemopneumothorax. Accordingly, patients' clinical features in different phases were collected and compared to determine the outcome difference and learning curve for uniportal VATS. Results    Median postoperative hospital stay was 5 days, and the overall complication rate was 8.1% (12/148). There was no 30-day death after surgery or readmissions. Median postoperative pain score was 3. Over time, the operation time, incision length and blood loss were optimized in the uniportal VATS lobectomy, the incision length and blood loss increased in the uniportal VATS segmentectomy, and the postoperative hospital stay decreased in the uniportal VATS wedge resection. Conclusion    Uniportal VATS is safe and feasible for both standard and complex pulmonary resections. While, no remarkable learning curve for uniportal VATS lobectomy is observed for experienced surgeon.

8.
Article in Chinese | WPRIM | ID: wpr-884345

ABSTRACT

Objective:To evaluate the value of shear wave dispersion imaging in identifying inflammatory reaction zone after liver ablation in rabbits.Methods:The animal model was made by laser ablation of rabbit liver, and then shear wave dispersion imaging and strain elastography imaging were performed on the ablation area at 3 d, 7 d, and 14 d after ablation. The shear wave dispersion values, elastic value and strain ratio measured by shear wave elastography, shear wave dispersion and strain elastography in different regions such as central necrotic tissue, surrounding inflammatory reaction zone and normal liver tissue after ablation were analyzed.Results:The shear wave dispersion values of inflammatory reaction zone around ablation site, necrotic tissue in the center of ablation site and normal liver tissue in rabbits were (26.07±4.55)m·s -1·kHz -1, (21.97±10.53)m·s -1·kHz -1and (15.45±3.94)m·s -1·kHz -1, respectively, the differences were statistically significant (all P<0.05). Compared with the three time points of 3 d, 7 d and 14 d after ablation, the shear wave dispersion value of the inflammatory zone was the highest on the 7th day after ablation ( P<0.05), while the elastic value and strain ratio in this region did not change significantly among these three time points ( P>0.05). Conclusions:Shear wave dispersion imaging can simultaneously measure tissue elasticity and viscosity, which has certain application value in identifying the inflammatory reaction zone around the ablation site in rabbit liver.

9.
Article in Chinese | WPRIM | ID: wpr-884284

ABSTRACT

Objective:To investigate the contrast-enhanced ultrasound (CEUS) features of inflammatory hepatocellular adenoma (I-HCA).Methods:The contrast-enhanced ultrasound features I-HCA of 28 cases from April 2009 to November 2019 in Zhongshan Hospital, Fudan University were retrospectively analyzed, including arterial phase enhancement pattern, the homogeneity of enhancement, subcapsular enhancement, and the internal perfusion defect. All I-HCA lesions were divided into >5 cm group( n=9) and ≤5 cm group( n=19), the CEUS features between the two groups were compared. Results:All I-HCA lesions were hyper-enhanced in the arterial phase, among which 39.3% (11/28) showed diffuse filling, 39.3%(11/28) showed centripetal filling, and 21.4%(6/28) showed centrifugal filling pattern. Twenty-five percent (7/28) of I-HCAs showed heterogeneous enhancement, 10.7% (3/28) revealed unenhanced areas within the lesions. Subcapsular vessels were observed in 67.7 (21/31) of I-HCA lesions. Heterogeneous enhancement and unenhanced areas were more frequently detected in lesions >5 cm ( P=0.020, 0.026, respectively), while there was no difference in the enhancement pattern and subcapsular vessels between the two groups ( P>0.05). Inportal venous phase, 42.9%(12/28) of I-HCAs showed hypo-enhancement, and 57.1%(16/28) of lesions showed washout in late phase. According to "hyper-enhancement in arterial phase, sustained hyper- or iso-enhancement in portal venous and late phase" by CEUS, the diagnostic accuracy of benign lesion was 42.9%(12/28). According to any of hyper-enhancement pattern in arterial phase, subcapsular vascular enhancement, and sustained hyper- or iso-enhancement in portal venous and late phase, the diagnostic accuracy of I-HCA was 71.4% (20/28). Conclusions:CEUS is valuable in the diagnosis of inflammatory hepatocellular adenoma.

10.
Article in Chinese | WPRIM | ID: wpr-865438

ABSTRACT

Objective To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus.Methods The clinical data of 117 patients with type 2 diabetes mellitus from January 2016 to June 2017 in Anhui No.2 Provincial People's Hospital were analyzed retrospectively.According to the eGFR level,the patients were divided into 3 groups:eGFR ≥ 90 ml/(min· 1.73 m2) in 68 cases (DM0 group),eGFR 60 to 89 ml/(min· 1.73 m2) in 33 cases (DM1 group),and eGFR < 60 ml/(min· 1.73 m2) in 16 cases (DM2 group).In addition,30 healthy people in the same period were selected as control group (NC group),eGFR ≥ 90 ml/(min · 1.73 m2).The systolic blood pressure,diastolic blood pressure,blood routine,glycosylated hemoglobin (HbA1c),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),urea nitrogen,creatinine and uric acid were recorded;and the NLR was calculated.The influencing factors of eGFR in patients with type 2 diabetic mellitus were analyzed,and the relationship between NLR and eGFR was evaluated.Results Compared with that in NC group and DM0 group,the eGFR in DM1 group and DM2 group was significantly lower:(75.12 ± 8.14) and (46.31 ± 13.25) ml/(min· 1.73 m2) vs.(114.17 ± 12.21) and (113.21 ± 12.04) ml/(min· 1.73 m2),the NLR was significantly higher:2.50 ± 1.16 and 2.75 ± 1.39 vs.1.53 ± 0.22 and 1.83 ± 0.65,and there were statistical differences (P < 0.05).Compared with that in DM1 group,the eGFR in DM2 group was significantly lower,the NLR was significantly higher,and there were statistical differences (P < 0.05).There were no statistical differences in NLR and eGFR between DM0 group and NC group (P > 0.05).Correlation analysis result showed that NLR,age,course of disease,systolic blood pressure,TC,HDL-C,urea nitrogen,creatinine and uric acid were negatively correlated with eGFR (r =-0.415,-0.555,-0.491,-0.432,-0.259,-0.237,-0.584,-0.840 and-0.261;P < 0.05);gender,diastolic pressure,HbA1c,TG and LDL-C were not correlated with eGFR (P > 0.05).Multiple linear regression analysis result showed that NLR,age,TC,creatinine and systolic blood pressure were independent risk factors of eGFR in patients with type 2 diabetes mellitus (P < 0.01 or <0.05).Conclusions There is a close relationship between the increase of NLR and the decrease of eGFR in patients with type 2 diabetes mellitus.Monitoring NLR is helpful to understand the changes of eGFR in patients with type 2 diabetes mellitus.

11.
Article in Chinese | WPRIM | ID: wpr-872195

ABSTRACT

Objective:To investigate the current basic situation of the staff of ultrasound departments in Shanghai′s medical institutions, for providing references in making management policy of these professionals.Methods:Questionnaire surveys on human resource and service ability were made to all the ultrasound departments of medical institutions in Shanghai in December 2013 and November 2018 respectively. Data of the two surveys were compared and analyzed, and were descriptively analyzed by mean and percentage.Results:The number of ultrasound professionals per 10 000 people in Shanghai was 1.04 in 2018. Tertiary hospitals had advantages in the number of the professionals, and the proportion of professional qualification, age, education background and professional title of the professionals. Compared to those data in 2013, the number of ultrasound professionals had increased 31.8% in 2018. The proportion of medical practitioners with medical imaging specialty was 95.6%(2 063/2 158), and had increased by 4.7 percent. The medical services workload of ultrasound was 19.82 million person-time, and had increased 45.8%.Conclusions:Development of ultrasound departments was rapid, but the development of professionals was unbalanced with the development of medical services. It is suggested to strengthen training of ultrasound professionals and improve the system of hierarchical medical system.

12.
Article in Chinese | WPRIM | ID: wpr-868068

ABSTRACT

Objective:To explore the value of contrast-enhanced ultrasound(CEUS) in distinguishing of renal oncocytoma(RO) and chromophobe renal cell carcinoma(chRCC).Methods:The ultrasonic image features of 49 ROs and 72 chRCCs between October 2007 and January 2020 were retrospectively analyzed, all lesions underwent ultrasonic examination (including 19 ROs and 70 chRCCs with CEUS imaging) and were pathologically approved in our institution. The statistically significant parameters from univariate analyses were then entered for further multivariable Logistic regression. The value of each ultrasonic imaging feature in differentiating RO and chRCC was evaluated.Results:According to the univariate analyses, all imaging features on conventional ultrasound were not statistically different between RO and chRCC (all P>0.05), while the characteristics of tumor wash-in/out pattern, enhancement degree and homogeneity at peak time and pseudocapsule around tumor were significantly different (all P<0.05). After multivariable analyses, tumor wash-in and wash-out pattern were excluded for tumor differentiation ( P>0.05), and the parameters of enhancement degree or homogeneity at peak time and pseudocapsule around tumor were still significantly different between tumor types (all P<0.05, odd ratio was 8.683, 6.667 and 18.774 respectively). The overall sensitivity, specificity and accuracy of these three parameters in diagnosing RO was 68.4%, 91.4% and 86.5%, respectively. Conclusions:CEUS can provide some useful information for the differentiation of RO and chRCC.

13.
Article in Chinese | WPRIM | ID: wpr-868060

ABSTRACT

Objective:To investigate the value of contrast-enhanced ultrasonography (CEUS) in detecting minute renal cell carcinoma (MRCC) smaller than 15 mm (by ultrasonic measurement) and the strategy to improve its detection rate.Methods:Fifty-three pathologically confirmed MRCCs by surgery from November 2007 to October 2019 at Zhongshan Hospital of Fudan University were enrolled in this retrospectively study. All of them underwent both conventional ultrasound and CEUS examinations. The clinical and imaging data were collected and analyzed. Common features, such as tumor size, location, echogenicity, morphology, border, and blood flow signals were observed on conventional ultrasound. On CEUS, the presence of enhancement, wash in and wash out pattern, perfusion uniformity within the lesions were observed.Results:Post-operative pathology confirmed 48 clear cell carcinomas, 4 papillary carcinomas, and 1 chromophobe cell carcinoma. On conventional ultrasound, 12/53 lesions showed no protrusion out of the kidney, and 41/53 cases slightly protruded out of the kidney. There was considerable difficulty in the detection of ten lesions, which was achieved with the guidance of CT/MRI, due to their dorsal location of the kidney. On conventional ultrasound, solid, hyper-echoic, color flow signal with varying degrees were the main features of MRCC.The boundary could be well- or ill-defined, and cystic changes existed in part of cases. On CEUS, most MRCCs showed simultaneous enhancement in cortical phase, iso- to hyper-enhancement at peak, and rapid washout in parenchymal phase. The comparisons of imaging features demonstrated that the characteristics were significantly different between conventional ultrasound and CEUS with regard to boundaries, blood supply, and perfusion uniformity (χ 2=12.425, 20.247, 7.185; all P<0.01). Conclusions:CEUS can significantly improve the detection rate of MRCC, which is superior to conventional ultrasound.

14.
Article in Chinese | WPRIM | ID: wpr-867978

ABSTRACT

Objective:To investigate the current basic situation of ultrasound machines of ultrasound departments in Shanghai medical institutions, and to provide the basis for making management policy in order to promote medical quality.Methods:Questionnaire surveys about ultrasound machines and service ability including producing countries of ultrasound machines, the number of ultrasound machines, using years of ultrasound machines, yearly workload and the yearly number of patients that each ultrasound machine accepted were made in 2013 and 2018, respectively. Statistical results were compared between the two surveys.Results:Compared with 2013, the share of imported ultrasound machines declined in 2018 (82% vs 91%). Compared with 2013, the number of ultrasound machines in Shanghai medical institutions had increased by 31% in 2018 (2 123 vs 1 617). The occupancy rate of ultrasound machines in tertiary hospitals was the highest (tertiary hospitals 40%, secondary hospitals 25%, primary grade hospitals 20%, and private hospitals 15%). Compared with 2013, the proportion of ultrasound machines that have been used for more than 10 years increased (9% vs 4%), the yearly workload of ultrasound examination had increased by 46% (19.82 million person-time vs 13.59 million person-time). Tertiary hospitals bored the highest proportion of the workload (tertiary hospitals 51%, secondary hospitals 35%, primary grade hospitals 4%, and private hospitals 10%). Currently, the number of ultrasound machines per 10, 000 people in Shanghai was 1.14. The yearly number of patients that each ultrasound machine accepted had increased by 11% (9300 person-time vs 8400 person-time in 2018).Conclusions:The scale of ultrasound departments in Shanghai medical institutions has been developing. Brand localization of ultrasound machines is improving. However, the renewal ability of ultrasound machines still needs to be improved. The workload of ultrasound department is getting heavier. Hierarchical diagnosis and treatment is unbalanced.

15.
Article in Chinese | WPRIM | ID: wpr-862523

ABSTRACT

Objective To explore the differences in clinical symptoms and laboratory examination indexes between patients with HIV/AIDS infection complicated with tuberculosis (TB) and those with HIV/AIDS alone, so as to provide a reference for early identification and diagnosis of HIV/AIDS infection with TB. Methods A total of 206 patients with HIV/AIDS infection and TB who were admitted to Suining Central Hospital from January 2015 to April 2019 were selected as the study group. 86 patients with pure HIV/AIDS were selected as the disease control group. Data of clinical diagnosis and treatment as well as follow-up of the patients were retrospectively analyzed. The clinical symptoms, laboratory examination indexes and clinical treatment outcomes were compared between the two groups. Results The incidence rates of fever, emaciation, electrolyte imbalance, hypoproteinemia, cough and chest pain in the study group were significantly higher than those in the disease control group (P0.05). The positive rates of sputum smear acid fast stain, sputum mycobacterium tuberculosis culture and PPD test in the study group were significantly higher than those in the disease control group, while the CD3+ count, CD4+ count and CD4+/CD8+ were obviously lower than the disease control group (P0.05). The ROC curve suggested that the areas under the curve of CD3+, CD4+, CD4+/ CD8+ and the three combined indicators to evaluate HIV/AIDS infection combined with TB were 0.799, 0.841, 0.913, and 0.935, respectively. The hospitalization time in the study group was significantly longer than that in the disease control group. The proportion of discharged patients (improved) in the study group was significantly lower than that in the disease control group, while the proportion of discharged patients (not improved) was significantly higher than that in the disease control group (P<0.05). Conclusion Although the clinical symptoms of patients with HIV/AIDS infection combined with TB are similar to those of patients with HIV/AIDS alone, the main symptoms of the former are fever, emaciation and electrolyte imbalance. The detection of laboratory immune function indexes is of positive significance for improvement of the diagnostic sensitivity and accuracy of HIV/AIDS infection with TB.

16.
Organ Transplantation ; (6): 589-2020.
Article in Chinese | WPRIM | ID: wpr-825576

ABSTRACT

Objective To explore the clinical value of virtual touch tissue quantification (VTQ) technique in the diagnosis of acute rejection of transplant kidney at different stages. Methods Clinical data of 170 renal transplant recipients were retrospectively analyzed. According to the time of VTQ examination and the occurrence of acute rejection after renal transplantation, the recipients within 4 weeks and after 4 weeks post-renal transplantation were assigned into the normal renal function group (n=41, 51) and acute rejection group (n=22, 56). Clinical ultrasound parameters at different stages after renal transplantation were compared between two groups. The diagnostic value of ultrasound parameters in acute rejection at different stages after renal transplantation was evaluated. Results Within 4 weeks post-renal transplantation, the resistance index (RI) and shear wave velocity (SWV) in the acute rejection group were significantly higher than those in the normal renal function group (both P < 0.001). After 4 weeks post-renal transplantation, the SWV in the acute rejection group was significantly higher than that in the normal renal function group (P < 0.001). The area under curve (AUC) of RI and SWV in the diagnosis of acute rejection were 0.729 and 0.803 respectively within 4 weeks post-renal transplantation, which were 0.478 and 0.794 respectively after 4 weeks post-renal transplantation. The diagnostic value of SWV was higher than RI (P < 0.05). The cutoff value of SWV in the diagnosis of acute rejection within 4 weeks post-renal transplantation was considerably higher than that after 4 weeks post-renal transplantation. Conclusions VTQ technique can effectively assist in diagnosing acute rejection of transplant kidney at different stages.

17.
Article in Chinese | WPRIM | ID: wpr-799153

ABSTRACT

Objective@#To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus.@*Methods@#The clinical data of 117 patients with type 2 diabetes mellitus from January 2016 to June 2017 in Anhui No.2 Provincial People′s Hospital were analyzed retrospectively. According to the eGFR level, the patients were divided into 3 groups: eGFR ≥ 90 ml/(min·1.73 m2) in 68 cases (DM0 group), eGFR 60 to 89 ml/(min·1.73 m2) in 33 cases (DM1 group), and eGFR<60 ml/(min·1.73 m2) in 16 cases (DM2 group). In addition, 30 healthy people in the same period were selected as control group (NC group), eGFR ≥ 90 ml/(min·1.73 m2). The systolic blood pressure, diastolic blood pressure, blood routine, glycosylated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), urea nitrogen, creatinine and uric acid were recorded; and the NLR was calculated. The influencing factors of eGFR in patients with type 2 diabetic mellitus were analyzed, and the relationship between NLR and eGFR was evaluated.@*Results@#Compared with that in NC group and DM0 group, the eGFR in DM1 group and DM2 group was significantly lower: (75.12 ± 8.14) and (46.31 ± 13.25) ml/(min·1.73 m2) vs. (114.17 ± 12.21) and (113.21 ± 12.04) ml/(min·1.73 m2), the NLR was significantly higher: 2.50 ± 1.16 and 2.75 ± 1.39 vs. 1.53 ± 0.22 and 1.83 ± 0.65, and there were statistical differences (P<0.05). Compared with that in DM1 group, the eGFR in DM2 group was significantly lower, the NLR was significantly higher, and there were statistical differences (P<0.05). There were no statistical differences in NLR and eGFR between DM0 group and NC group (P>0.05). Correlation analysis result showed that NLR, age, course of disease, systolic blood pressure, TC, HDL-C, urea nitrogen, creatinine and uric acid were negatively correlated with eGFR (r=-0.415, -0.555, -0.491, -0.432, -0.259, -0.237, -0.584, -0.840 and -0.261; P < 0.05); gender, diastolic pressure, HbA1c, TG and LDL-C were not correlated with eGFR (P > 0.05). Multiple linear regression analysis result showed that NLR, age, TC, creatinine and systolic blood pressure were independent risk factors of eGFR in patients with type 2 diabetes mellitus (P<0.01 or < 0.05).@*Conclusions@#There is a close relationship between the increase of NLR and the decrease of eGFR in patients with type 2 diabetes mellitus. Monitoring NLR is helpful to understand the changes of eGFR in patients with type 2 diabetes mellitus.

18.
Article in Chinese | WPRIM | ID: wpr-799090

ABSTRACT

Objective@#To investigate the current basic situation of ultrasound machines of ultrasound departments in Shanghai medical institutions, and to provide the basis for making management policy in order to promote medical quality.@*Methods@#Questionnaire surveys about ultrasound machines and service ability including producing countries of ultrasound machines, the number of ultrasound machines, using years of ultrasound machines, yearly workload and the yearly number of patients that each ultrasound machine accepted were made in 2013 and 2018, respectively. Statistical results were compared between the two surveys.@*Results@#Compared with 2013, the share of imported ultrasound machines declined in 2018 (82% vs 91%). Compared with 2013, the number of ultrasound machines in Shanghai medical institutions had increased by 31% in 2018 (2 123 vs 1 617). The occupancy rate of ultrasound machines in tertiary hospitals was the highest (tertiary hospitals 40%, secondary hospitals 25%, primary grade hospitals 20%, and private hospitals 15%). Compared with 2013, the proportion of ultrasound machines that have been used for more than 10 years increased (9% vs 4%), the yearly workload of ultrasound examination had increased by 46% (19.82 million person-time vs 13.59 million person-time). Tertiary hospitals bored the highest proportion of the workload (tertiary hospitals 51%, secondary hospitals 35%, primary grade hospitals 4%, and private hospitals 10%). Currently, the number of ultrasound machines per 10, 000 people in Shanghai was 1.14. The yearly number of patients that each ultrasound machine accepted had increased by 11% (9300 person-time vs 8400 person-time in 2018).@*Conclusions@#The scale of ultrasound departments in Shanghai medical institutions has been developing. Brand localization of ultrasound machines is improving. However, the renewal ability of ultrasound machines still needs to be improved. The workload of ultrasound department is getting heavier. Hierarchical diagnosis and treatment is unbalanced.

19.
Article in Chinese | WPRIM | ID: wpr-798680

ABSTRACT

Objective@#To investigate the current basic situation of the staff of ultrasound departments in Shanghai′s medical institutions, for providing references in making management policy of these professionals.@*Methods@#Questionnaire surveys on human resource and service ability were made to all the ultrasound departments of medical institutions in Shanghai in December 2013 and November 2018 respectively. Data of the two surveys were compared and analyzed, and were descriptively analyzed by mean and percentage.@*Results@#The number of ultrasound professionals per 10 000 people in Shanghai was 1.04 in 2018. Tertiary hospitals had advantages in the number of the professionals, and the proportion of professional qualification, age, education background and professional title of the professionals. Compared to those data in 2013, the number of ultrasound professionals had increased 31.8% in 2018. The proportion of medical practitioners with medical imaging specialty was 95.6%(2 063/2 158), and had increased by 4.7 percent. The medical services workload of ultrasound was 19.82 million person-time, and had increased 45.8%.@*Conclusions@#Development of ultrasound departments was rapid, but the development of professionals was unbalanced with the development of medical services. It is suggested to strengthen training of ultrasound professionals and improve the system of hierarchical medical system.

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Article in Chinese | WPRIM | ID: wpr-791294

ABSTRACT

Objective To investigate the initial clinical value of shear wave elastography ( SWE ) combined with shear wave dispersion ( SWD) in preoperatively differentiating diagnosis of focal liver lesions ( FLLs) . Methods Eighty‐three patients diagnosed as FLLs were prospectively enrolled from January to April 2018 in Zhongshan Hospital of Fudan University . M easurements of SWD and SWE both inner FLLs and surrounding liver parenchyma 2 cm away from the board lines of lesions were performed . ROIs were placed within the lesions and surrounding parenchyma 2 cm away from the lesions . In each ROI , measurements were performed 13 times . Histopathological results after operation were regarded as gold standard ,and the values of viscoelasticity in differentiating diagnosis of FLLs were analyzed . Results The final histopathological results showed that of all 83 cases ,20 cases were diagnosed as benign lesions ( 5 cases of focal nodular hyperplasia ,15 cases of hemangioma) ,and 63 cases as malignant lesions ( 12 cases of liver metastases ,51 cases of hepatocellular carcinoma) . T he SWE of benign lesions and malignant lesions were ( 9 .94 ± 8 .22) kPa ,and ( 13 .68 ± 7 .80) kPa( P <0 .05 ) . T he SWD of benign lesions and malignant lesions were ( 13 .47 ± 2 .76 ) ( m/s)/kHz ,and ( 15 .00 ± 3 .82 ) ( m/s)/kHz ( P <0 .05 ) . T he SWE ratio and SWD ratio of benign lesions to surrounding liver parenchyma were higher than those of malignant lesions( all P <

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