Analysis of risk factors for acute moderate to high risk pulmonary thromboembolism in adults / 中国医师杂志

Objective:To investigate the risk factors according to the clinical data of the adult patients with acute moderate to high risk pulmonary thromboembolism (PTE).Methods:The clinical data of 100 adult patients with acute moderate-risk PTE in Hunan Provincial People′s Hospital from June 2019 to March 2022 were analyzed retrospectively. According to the risk stratification, they were divided into moderate to low risk group (34 cases) and moderate to high risk group (66 cases). The laboratory data and clinical data of all adult patients were collected, and the independent risk factors of acute moderate to high risk PTE in adults were analyzed by binary logistic regression; Receiver operating characteristic (ROC) curve was used to analyze the predictive ability of independent risk factors for acute moderate to high risk PTE.Results:There were 34 patients with moderate to low risk PTE, 20 males and 14 females, aged 16-86 (60.2±15.5)years, 66 patients with moderate to high risk PTE, 36 males and 30 females, aged 34-82(63.6±9.6)years. There was no significant difference in age, gender and risk factors between the two groups (all P>0.05). The tumor history of concomitant diseases in moderate to high risk group was significantly higher than that in moderate to low risk group, and the symptoms of dyspnea and shortness of breath in moderate to high risk group were significantly higher than those in moderate to low risk group (all P>0.05). The levels of troponin I, shock index (SI) and N-terminal B-type brain natriuretic peptide precursor (NT-proBNP) in moderate to high risk group were significantly higher than those in moderate to low risk group, while the levels of PaO 2 and oxygenation index in moderate to high risk group were significantly lower than those in moderate to low risk group, with statistical significant difference (all P<0.05). Echocardiographic results showed that there were significant differences in right ventricular inner diameter (RV), left ventricular inner diameter (LV), RV/LV, tricuspid regurgitation velocity and pulmonary systolic pressure between moderate to high risk PTE patients and moderate to low risk PTE patients (all P>0.05). CTPA results showed that RV, RV/LV, main pulmonary artery diameter and thrombus load in moderate to high risk PTE patients were significantly higher than those in moderate to low risk PTE patients (all P<0.05). Multivariate binary logistic regression analysis showed that SI, NT-proBNP and RV were independent predictors of moderate to high risk PTE (all P<0.05). The combined detection of SI, NT-proBNP and RV had a good predictive value for moderate to high risk PTE. The area under ROC curve (AUC) was 0.984, the sensitivity and specificity were 90.32% and 97.73%, respectively. The negative predictive value was 87.8%, and the positive predictive value was 98.2%. Conclusions:SI, NT-proBNP, RV of echocardiography and RV of CTPA are the predictors of acute moderate to high risk PTE in adults, which provided a strong supplement for the risk stratification of acute moderate risk PTE in adults.

Detection of epidermal growth factor receptor mutations in non-small cell lung cancer by immunohistochemistry / 中南大学学报(医学版)

OBJECTIVES@#To evaluate the sensitivity and specificity of immunohistochemistry (IHC) for detecting common epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) and to estimate the cost-effectiveness of IHC testing.@*METHODS@#A total of 208 NSCLC patients were included in the trial, and the EGFR mutation status in the patients were detected by PCR and IHC. Two mutation-specific antibodies against the most common exon 19 deletion (clone SP111) and exon 21 L858R mutation (clone SP125) were tested by using automated immunostainer. A cost-effectiveness analysis model was built for the analysis of optimal detection scheme.@*RESULTS@#With a cutoff value of IHC 1+, the overall sensitivity and specificity of the IHC-based method compared with the PCR-based method were 81.7% (95% CI 72.4% to 89.0%) and 94.7% (95% CI 92.6% to 99.5%), respectively. EGFR 19del mutation was detected by SP111 antibody with a sensitivity of 65.9% (95% CI 49.4% to 79.9%) and specificity of 98.8% (95% CI 95.7% to 99.9%). EGFR L858R mutation was detected by SP125 antibody with a sensitivity of 94.2% (95% CI 84.1% to 98.8%) and specificity of 99.4% (95% CI 96.5% to 100%). The IHC and PCR cost ratio needed to be 1-to-3 or more in our patients to economically justify before the use of IHC.@*CONCLUSIONS@#The study confirms an excellent specificity with fairly good sensitivity of IHC and mutation-specific antibodies for common EGFR mutations. It is cost-effective to use IHC method to detect EGFR mutation first when the IHC and PCR cost ratio is 1-to-3 or more in Chinese populations.

Expression and clinical significance of CXCL14 and EGFR in human gastric cancer / 中国肿瘤临床

Objective:To investigate the expression of C-X-C chemokine ligand-14 (CXCL14) and epidermal growth factor receptor (EG-FR) in human gastric cancer and to analyze the relationship of CXCL14 with clinicopathological features. Methods:The expression of CXCL14 and EGFR was detected by Immunohistochemical SP method in 121 cases of gastric cancer tissue, 62 cases of the adjacent non-tumor gastric mucosa, and 60 cases of allogeneic non-tumor gastric mucosa. Results:The positive rates of CXCL14 and EGFR expres-sion were 80.17%and 48.76%in gastric cancer, respectively, and both were significantly higher in the adjacent non-tumor gastric mu-cosa and allogeneic non-tumor gastric mucosa. The differences were significant (P<0.01). Overexpression of CXCL14 was closely corre-lated with the depth of cancer invasion, differentiation, and clinical stage, and the differences were significant (P<0.05). Overexpres-sion of EGFR was correlated with cancer differentiation, lymph node metastasis, and clinical stage. The differences were significant (P<0.05). Based on the Spearman correlation analysis, the expression of CXCL14 and EGFR in gastric cancer was positively correlated (rs=0.195, P<0.05). Conclusion:Abnormal CXCL14 expression in gastric cancer may be associated with the occurrence and development of gastric cancer. CXCL14 expression is positively correlated with EGFR expression, suggesting that the two have a synergistic effect in gas-tric cancer development.

Huge dentigerous cyst of maxilla: one case report / 临床耳鼻咽喉头颈外科杂志

Dentigerous cyst of maxilla is a rare disease in department of otorhinolaryngology. More than 2 week persistent infection of the cortex that is surrounded by dense bone and then begins absorption causing the formation of dentigerous cyst. One tooth germ or multiple tooth germs can be seen in the cysts, mostly in the third molar area and canine area. However, it is extremely rare that so huge dentigerous cyst of maxilla, in which include three additional teeth, that is why we report it.

Expression of SNCG and CXCR4 mRNAs in gastric adenocarcinoma and its clinical significance / 中国肿瘤临床

Objective:To detect expression of SNCG and CXCR4 mRNA in gastric adenocarcinoma and evaluate its function in carcinogenesis, progression, infiltration, and metastasis, as well as the correlation of these proteins. Methods:The expression of SNCG and CXCR4 mRNAs was detected using reverse transcription-polymerase chain reaction in gastric adenocarcinoma and normal gastric mucosa. Results:The expression of SNCG and CXCR4 mRNAs was obviously higher in gastric adenocarcinoma than in normal gastric mucosa (P<0.01). The expression of SNCG mRNA was closely correlated with tumor infiltration depth (P<0.05) and lymph node metas-tasis (P<0.01). The expression of CXCR4 mRNA closely correlated with lymph node metastasis (P<0.01). The expression of SNCG and CXCR4 mRNAs positively correlated in 29 cases of gastric adenocarcinoma (r=0.346, P<0.05). Conclusion:SNCG and CXCR4 may be overexpressed in tumor tissue and may have important functions in tumorigenesis, progression, infiltration, and metastasis of gastric adenocarcinoma.

PDCA circulation improves the effectiveness of disposable articles in the operation room / 现代临床护理

Objective To explore the effect of PDCA circulation on the effective utilization of the disposable articles in the operating room.Methods 9,362 aseptic articles for 446 operations in the departments of general surgery and hepatobiliary surgery during January to May 2012 were put in the pre-experiment group,in which PDCA circulation was not used.Another 11,973 articles for 501 operations in the same departments during June to November 2012 were set as the post-experiment group,in which PDCA circulation was used.The two groups were compared in terms of the effective utilization rate and the degree of doctor’s satisfaction with the nurses in the operation room.Result After the implementation of PDCA circulation,the effective utilization rate and the degree of doctor’s satisfaction were both significantly higher than before the implementation(both P<0.05).Conclusion PDCA circulation for the management of sterile disposable articles in the operation room may effectively improve the utilization rate of disposable articles, reduce wasting of articles and safe resources.

A probe into the administration of the surgery material / 中国实用护理杂志

Objective To carry out unified regulation to the purchase, using and administration of the surgery material, thus to improve the quality of medical work and the level of medical administration. Methods For the one-shot things, interlink administration was needed. For the precision instrument, we carried out the responsibility system within every specific section office, and the administration with pictures and codes. For the expensive instruments and equipments, we made registration and carry out personal responsibility system. We analyzed the existing problems and expected the computer network administration in the future. Results No surgery was affected because of the shortage of materials or the damage of the instruments or equipments. Conclusions With the efficient administration of the surgery material, we can improve the nursing quality in the operation room, avoid medical disputes, and make sure smooth operation, thus every patient can recover soon.

Determination of Selenium in Hair by Graphite Furnace Atomic Absorption Spectrometer / 环境与健康杂志

Objective To develop a simple, rapid, accurate method to determine selenium in human hair. Methods Digested in the superior grade pure nitric acid, Ni(NO3)2?6H2O was used as the improver and the content of selenium in the hair samples was determined by graphite furnace atomic absorption spectrometer. Results Under the designed standard conditions, the detection limit was 0.004 mg/L, in the range of 0.008-0.04 mg/L, the linearity relevance coefficient of absorbency and concentration was 0.996 9, the RSD was 3.7%. At the level of 0.01 mg/L, the recovery rates were 93.8%-98.8%. Conclusion The method is simple, rapid, accurate and is suitable for the determination of selenium in the hair.

Study of the Value of SCT in Diagnosis of Chronic Suppurative Otitis Media / 实用放射学杂志

Objective To evalute the value of spiral CT in diagnosis and treatment of chronic suppurative otitis media.Methods Sixty-five cases including seventy-nine ears underwent the direct axial plane and coronal multiplanar reformation and three-dimensional reconstruction of auditory ossicular chain in chronic suppurative otitis media spiral CT imaging of temporal bone. Results The direct axial plane and coronal multiplanar reformation in diagnosing of the chronic suppurativeotitis media were correspondent,but in showing of the most middle ear structure were difference. Three-dimensional images was superior to axial and coronal MPR images in showing of the change of malleus and incus,the contrary situation in showing stapes. Only 3D image may not select application for definition.The rate of agreement between spiral CT diagnosis by combination of three different imaging methods and definition of chronic suppurative otitis media and operative findings(89.9%～97.5%) were higher, false positive rate(2.9%～6.0%) and false negative rate(0～14.6%) of the CT diagnosis were lower.Conclusion Combination of three different imaging methods(axial images, coronal MPR images and three-dimensional images of the ossicular chain) can improve the value of the spiral CT diagnosis and therapy of chronic otitis media.

CT Diagnosis of Atypical Meningioma / 实用放射学杂志

Objective To explore CT diagnosis of atypical meningioma .Methods 18 cases of atypical meningioma were undergone MR plan scans, among them,17 cases were examined by CT contrast scans. All cases were proved by operation and pathology.Results The tumors appeared as mixed density in 11 cases,cystic in 4 cases,complete enhancement in 3 cases.Conclusion The tumors to be comfirmed at external cerebra is the key in diagnosing atypical meningioma exactly by CT.Atypical manifestations can be seen in a few meningiomas,therefore, it is significant in differential diagnosis of meningioma.

Imaging Features and Diagnosis of Vertebral Hemangioma / 实用放射学杂志

Objective To analyse the features of vertebral hemangioma and inaging diagnostic value of vertebral hemangioma.Methods There were 14 cases with hemangioma proved by clinic and pathology.X-ray plain was performed in all cases,of which 9 cases were performed by CT scan and,only 6 cases were taken MR,and 2 cases had both CT and MR scan.Results The tumors were located in thoracic spine in 10 cases,in lumbar spine in 3 cases and in cervical spine in 1 case.8 cases showed typically fence-like or nest-like;the verterea were irregularly destroyed in 5 cases,of which 2 cases were associated with vertebrea collapsing.According to the features in plain film and CT scan,there were 2 cases misdiagnosed,but 6 cases were all made a correct diagnosis on the base of MR before surgry.Conclusion Typical vertebral hemangima can be diagnosed correctely according to plain film or CT while MR plays an important role in atypical cases.