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@#Objective To explore the key points and difficulties of intraoperative frozen section diagnosis of pulmonary diseases. Methods The intraoperative frozen section and postoperative paraffin section results of pulmonary nodule patients in Beijing Chaoyang Hospital, Capital Medical University from January 2021 to January 2022 were collected. The main causes of misdiagnosis in frozen section diagnosis were analyzed, and the main points of diagnosis and differential diagnosis were summarized. Results According to the inclusion criteria, a total of 1 263 frozen section diagnosis results of 1 178 patients were included in the study, including 475 males and 703 females, with an average age of 58.7 (23-86) years. In 1 263 frozen section diagnosis results, the correct diagnosis rate was 95.65%, and the misdiagnosis rate was 4.35%. There were 55 misdiagnoses, including 18 (3.44%) invasive adenocarcinoma, 17 (5.82%) adenocarcinoma in situ, 7 (35.00%) mucinous adenocarcinoma, 4 (2.09%) minimally invasive adenocarcinoma, 3 (100.00%) IgG4 related diseases, 2 (66.67%) mucinous adenocarcinoma in situ, 1 (16.67%) atypical adenomatous hyperplasia, 1 (14.29%) sclerosing pulmonary cell tumor, 1 (33.33%) bronchiolar adenoma, and 1 (100.00%) papillary adenoma. Conclusion Intraoperative frozen section diagnosis still has its limitations. Clinicians need to make a comprehensive judgment based on imaging examination and clinical experience.
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Based on UPLC-Q-orbitrap-MS and biological network analysis tools, the mechanism of Xihuang Pill in improving hyperplasia of mammary glands was systematically analyzed. The rat model of hyperplasia of mammary glands was established by intramuscular injection of estradiol benzoate and progesterone. LC-MS tissue metabolomics was used to explore the key metabolites and metabolic pathways of Xihuang Pill in improving hyperplasia of mammary glands in rat. The network analysis of the key metabolites regulated by Xihuang Pill was carried out by integrating biological network analysis tools, focusing on the key metabolic pathways, and exploring the potential targets of Xihuang Pill to improve hyperplasia of mammary glands. Compared with the control group, there were significant differences in the content of 49 differential metabolites in the tissues of the model group (P < 0.05). Xihuang Pills could significantly call back 17 metabolites such as L-alanine, threonine, indole-3-carboxylic aldehyde, lysine, arginine, alanylleucine, glycyltyrosine, γ-glutamyl leucine, vitamin B3, serine leucine, threonine leucine, isoleucine glutamic acid, γ-glutamyl tyrosine, decanoyl-L-carnitine, uric acid, leucylleucine, S-adenosyl-methionine. Further network analysis and literature research on the key metabolites regulated by Xihuang Pills showed that the AGE-RAGE signaling pathway may be one of the important pathways for Xihuang Pills to improve hyperplasia of mammary glands. STAT3, MAPK1, EGFR, CASP3, CASP8, PRKCA and JUN in the AGE-RAGE signaling pathway may be potential targets for Xihuang Pills to improve hyperplasia of mammary glands. The animal experiment operations involved in this paper follow the provisions of the Animal Ethics Committee of Gansu University of Traditional Chinese Medicine and pass the ethical review of animal experiments (approval number: 2022-705).
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OBJECTIVE To establish the quality control method for the roots and rhizoma of Toricellia angulata. METHODS The properties of the roots and rhizoma of T. angulata were observed and microscopic identification was conducted. The moisture， total ash， acid-insoluble ash and ethanol-soluble extract were examined according to the method stated in the 2020 edition of Chinese Pharmacopoeia （part Ⅳ）. HPLC fingerprints of 11 batches of the roots and rhizoma of T. angulata were established， common peaks were identified and the similarity was evaluated by using the Similarity Evaluation System of Chromatographic Fingerprint of TCM （2012 edition）. The contents of coniferin， syringin， chlorogenic acid， （+）-syringaresinol-O-β-D-glucopyranoside and syringaresinol were determined by HPLC. RESULTS The properties and microscopic identification of the roots and rhizoma of T. angulata were obvious. The average contents of moisture， total ash， acid-insoluble ash and ethanol-soluble extract were 7.54%， 2.18%， 0.15% and 7.81%， respectively. There were 16 common peaks marked in the HPLC fingerprints of 11 batches of the roots and rhizoma of T. angulata， with similarities of 0.856-0.960； five of them were identified， such as coniferin， syringin， chlorogenic acid， （+）-syringaresinol-O-β-D-glucopyranoside and syringaresinol. The contents of the above five components were 0.047 2-0.401 6， 0.836 8-8.697 9， 1.245 3-10.950 0， 0.139 0-0.437 8 and 0.016 4-0.635 3 mg/g， respectively. CONCLUSIONS The established method is stable and accurate， which can be used for the quality control of the roots and rhizoma of T. angulata. It is preliminarily proposed that the moisture in the roots and rhizoma of T. angulata is not more than 11.0%， the total ash is not more than 4.0%， the ethanol-soluble extract is not less than 5.0%， the contents of coniferin， syringin， chlorogenic acid， （+）-syringaresinol-O-β-D- glucopyranoside and syringaresinol are not less than 0.04，0.83， 1.24， 0.13， 0.01 mg/g， respectively.
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This paper investigates the effect of myricetin (MYR) on renal fibrosis induced by unilateral ureteral obstruction (UUO) and common bile duct ligation (CBDL) in mice and its mechanism. The animal experiment has been approved by the Ethics Committee of China Pharmaceutical University (NO: 2022-10-020). Thirty-five ICR mice were divided into control, UUO, UUO+MYR, CBDL and CBDL+MYR groups. H&E and Masson staining were used to detect pathological changes in kidney tissues. Western blot (WB) was used to detect the expression of fibrosis-related proteins in renal tissue, and total superoxide dismutase (SOD) activity detection kit (WST-8) was used to detect the changes of total SOD in renal tissue of CBDL mice. In vitro, HK-2 cells and transforming growth factor beta 1 (TGF-β1, 10 ng·mL-1) were used to induce fibrotic model, and high glucose (30 mmol·L-1) was used to induce oxidative stress model, and then treated with different concentrations of MYR, WB was used to detect the expression of fibrosis and oxidative stress-related proteins, while NIH/3T3 cells were treated with different concentrations of MYR, and their effects on cell proliferation were detected by 5-bromo-2′-deoxyuridine (Brdu). The results showed that the renal lesions in UUO group and CBDL group were severe, collagen deposition was obvious, the expression of collagen-Ⅰ (COL-Ⅰ), α-smooth muscle actin (α-SMA), fibronectin (FN), vimentin and plasminogen activator inhibitor-1 (PAI-1) protein was up-regulated, and the activity of SOD enzyme in CBDL group was significantly decreased. MYR partly reversed the above changes after treatment. MYR inhibited the proliferation of NIH/3T3 cells but had no effect on the proliferation of HK-2 cells, and decreased the upregulation of PAI-1, FN and vimentin in HK-2 cells stimulated by TGF-β1. MYR can also up-regulate the down-regulation of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in HK-2 cells stimulated by high glucose. To sum up, MYR can improve renal fibrosis in vivo and in vitro, probably by inhibiting the proliferation of fibroblasts and activating Nrf2/HO-1 signal pathway to inhibit oxidative stress.
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The aim is to evaluate the effect of therapeutic communication on cervical cancer patients’ preoperative anxiety and hope level. The convenience sampling method was used to select the inpatients who will receive radical surgery for cervical cancer in the department of obstetrics and gynecology of the Second Affiliated Hospital of Xi’an Jiaotong University from November 2016 to November 2019 as the research object. 50 patients were grouped by the random number table method: 25 patients were in the intervention group, and 25 patients were in the control group. Patients in the intervention group were given therapeutic communication on the basis of routine nursing, and patients in the control group were given routine nursing. Both groups were investigated with the Self-Rating Anxiety Scale (SAS) and Herth Hope Index (HHI) on the first day of admission and the day before surgery. Before the intervention, there was no statistically significant difference between the two groups (P>0.05) . After the intervention, the anxiety level of the intervention group was lower than that of the control group (P<0.05), and the hope level was higher than that of the control group (P<0.05). It can be seen that therapeutic communication can alleviate preoperative anxiety of cervical cancer patients, improve their hope level, promote patient recovery, and ease tense medical relationship.
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Objective:To explore the feasibility of rapid identification of methicillin-resistant Staphylococcus aureus using different algorithms of the matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometer. Methods:Totally 314 clinical isolates of Staphylococcus aureus were selected from the bacterial bank at Beijing Tongren Hospital from January 2017 to June 2019. The samples were identified by MALDI-TOF MS, and screened by cefoxitin disk method (inhibition ring diameter ￡21 mm) and PCR mecA gene. The strains were divided into a methicillin-resistant Staphylococcus aureus (MRSA) group (130 strains) and a methicillin-susceptible Staphylococcus aureus (MSSA) group (184 strains). Then, after collecting the spectrograms of these samples using formic acid extraction, the MRSA group and MSSA group were divided into three subgroups each, namely MRSA-1 (43 strains), MRSA-2 (42 strains), MRSA-3 (45 strains) and MSSA-1 (60 strains), MSSA-2 (61 strains) and MSSA-3 (63 strains). The groups were studied using genetic algorithm (GA), fast classification algorithm (QC) and supervised neural network algorithm (SNN) in the ClinProTools software on the Bruker MALDI-TOF mass spectrometer, and the convolutional neural network algorithm (CNN) in the Ex-SmartSpec software on the Zhongyuan Hui-Ji mass spectrometer. These studies were repeated for 3 rounds. The first round with MRSA-1 and MRSA-2, MSSA-1 and MSSA-2 being model groups, MRSA-3 and MSSA-3 being validation groups. The validation groups were rotated for each round. The areas under the receiver operating characteristic (ROC) curve expansions of the four algorithms were used to confirm each program′s performance. Then, 38 MRSA strains and 40 MSSA clinical strains were selected from the bacterial bank of the Laboratory of Beijing Tongren Hospital from July 2019 to December 2019, and were put through the formic acid extraction method to collect their spectra. These samples were tested independently with their convolutional neural network models. Results:After three rounds of modeling and verification, the areas under the ROC curves of the three Bruker ClinProTools programs were as follows: for genetic algorithm, the areas were 0.89, 0.74, and 0.64 respectively; for fast classification algorithm, the areas were 0.77, 0.95, and 0.94 respectively; and for supervised neural network algorithm, the areas were 0.90, 0.98, and 0.98 respectively. The areas under the ROC curves of the convolutional neural network algorithm with Zhongyuan Huiji mass spectrometer′s Ex-SmartSpec software were 0.95, 0.99, and 0.99 respectively. The independent test results of convolutional neural network algorithm showed that these results have an accuracy, specificity, sensitivity and AUC of 88.82% (810/912), 81.15% (779/960), 84.88% (1 589/1 872) and 0.92 respectively.Conclusions:The supervised neural network algorithm of Bruker′s ClinProTools and the convolutional neural network algorithm of Zhongyuan Hui-Ji mass spectrometer′s EX-Smartspec is clinically acceptable for rapid identification of MRSA performance indicators. Using convolutional neural network algorithm and MALDI-TOF mass spectrometry, MRSA strains can be identified quickly, providing timely advice for clinical medications.
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Objective:To observe any effect of combining music exercise with transcranial direct current stimulation (tDCS) on the motor control, balance and cognition of persons with Parkinson′s disease (PD).Methods:A total of 120 PD patients were randomly divided into a control group, a music exercise group, a tDCS group and a combined group, each of 30. All received routine rehabilitation training, while the music exercise, tDCS and combined groups were additionally provided with music exercise therapy, tDCS treatment or both, respectively. Version three of the unified Parkinson′s disease scale (UPDRSIII), a 10m reentry movement test, the Berg balance scale (BBS), the Activity Balance Confidence scale (ABC) and Montreal cognitive assessments were applied before and after 4 weeks of the treatments.Results:After the treatment, the average UPDRSIII score and 10m reentry movement time of the music exercise group were significantly lower than in the control group, while the average BBS and ABC scores were significantly higher than the control group′s averages. The tDCS group′s average MoCA scores on all of the items and its total score were significantly higher than those of the music exercise and control groups. The average UPDRSIII score and 10m reentry movement time of the combined group were the lowest after the treatment, and that group′s average BBS, ABC, MoCA and total scores were the highest, significantly better than the other three groups.Conclusion:Combining music exercise training with tDCS can effectively improve the motor functioning, balance and cognition of persons with PD.
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Objective:To explore any effect of supplementing low-frequency repeated transcranial magnetic stimulation (rTMS) with intermittent resistance training on muscle tone and the recovery of motor function among persons with Parkinson′s disease (PD).Methods:A total of 104 PD patients were randomly divided into an observation group and a control group, each of 52. Both groups were treated with conventional drugs and low-frequency rTMS, while the observation group was additionally provided with intermittent resistance training for 8 weeks. Before and after the intervention, the motor functioning of both groups was evaluated using unified Parkinson′s disease rating scale-III (UPDRS-III) and the Berg Balance Scale (BBS). Limb muscle tension was quantified using the modified Ashworth scale (MAS). The subjects′ psychological states were quantified using the exercise self-efficacy scale (ESE), and the modified Barthel index (MBI) was applied to evaluate their ability in the activities of daily living. A 3D motion processing system collected and analyzed data describing each subject′s gait kinematics.Results:After the intervention, significantly greater average improvement was observed in all of the outcome measures among the observation group compared with the control group.Conclusion:Combining intermittent resistance training with low-frequency rTMS can significantly reduce muscle tone and improve the motor functioning of PD patients. The combination is more effective than low-frequency rTMS alone.
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Objective:To observe any therapeutic effect of combining botulinum toxin type A (BTX-A) with rehabilitation training in treating Parkinson′s disease (PD) patients with striatal foot deformity (SFD).Methods:A total of 68 PD patients with SFD were randomly divided into a control group and a treatment group. Both groups were given routine medication with pramipexole and dopamine receptor agonists and received lower limb rehabilitation training, including passive activity training, strength training and walking training. The treatment group was additionally injected with BTX-A. Sciatic pain was quantified using a visual analogue scale. The Unified Parkinson′s Disease Rating Scale-lower limb motor lower limb motor function (UPDRS-LLM) scale, the Berg balance scale and the modified Barthel index were applied to test all of the participants before the experiment and on the 7th, 14th and 30th day of the treatment.Results:The average scores of the control group on all of measures at were significantly better than those of the control group at the same time points, and by the 14th and 30th day had improved significantly compared with those before treatment.Conclusion:Supplementing rehabilitation training with BTX-A can significantly improve foot deformity and relieve the muscle tension and spastic pain of PD patients with SFD, promoting the motor functioning of their lower limbs, their balance and their performance in the activities of daily living.
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Objective:To investigate relationships between serum growth differentiation factor 15 (GDF15) and glycolipid metabolism in patients with metabolic associated fatty liver disease (MAFLD).Methods:The current investigation was a cross-sectional study. A total of 333 patients from the Fengxian District Central Hospital were recruited into the study after physical examination from February 2020 to February 2021. There were 107 patients with MAFLD and type 2 diabetes mellitus (T2DM), including 54 males and 53 females with a mean age of (57±11) years. There were 65 patients with simple MAFLD only, including 32 men and 33 women with a mean age of (49±5) years. There were 105 patients with T2DM only, including 53 men and 52 women, with a mean age of (56±10) years. A control group of 56 people without MAFLD or diabetes,28 male, 28 female, mean age (48±6) years, was also included in the study. Serum GDF15 was measured via enzyme-linked immunosorbent assays. IBM SPSS 26.0 was used for statistical analysis. Logistic regression was used to evaluate relationships between GDF15 and metabolic abnormalities in MAFLD patients.Results:GDF15 progressively increased in the control [385 (296, 484) ng/L], nonobese MAFLD [388 (319, 435) ng/L], obese MAFLD [426 (354, 527) ng/L], T2DM [664 (483, 900) ng/L], and MAFLD+T2DM groups [770 (560, 1 074) ng/L]( H=113.82, P=0.001). There was no significant difference in serum GDF15 between the simple MAFLD [406 (339, 524) ng/L] and control group ( U=1 505.50, P=0.132). GDF15 was significantly higher in the MAFLD+T2DM group than in the T2DM-only group ( U=4 573.50, P=0.019). In logistic regression analysis increased GDF15 was associated with increased risks of simple MAFLD [odds ratio ( OR)=2.202], T2DM ( OR=29.656), and MAFLD+T2DM( OR=58.197). In patients with MAFLD, serum GDF15 was higher in the FIB4 index>1.45 group [773 (534, 1 162) ng/L] than in the FIB4 index<1.45 group [527 (389, 787) ng/L] ( U=1 709.50, P<0.001). Increased GDF15 was associated with an increased risk of advanced liver fibrosis ( OR=2.388). Conclusion:In patients with simple MAFLD, GDF15 level was not significantly higher than in the control group. In the T2DM-only group and the MAFLD+T2DM group GDF15 was significantly higher than in the control group. Increased serum GDF15 was associated with increased risk and severity of MAFLD complicated with abnormal glucose and lipid metabolism. High GDF15 increased the risk of advanced fibrosis in MAFLD patients.
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Objective:To construct an evaluation index system for core competence of nurses in the imaging department.Methods:The literature research and the opinions of the research team were integrated to develop indicators for core competence of imaging nurses at all levels. Delphi method was used to conduct 2 rounds of consultation with 20 experts, and analytic hierarchy process (AHP) was used to determine the index weights at all levels. The indicators were converted into a self-assessment scale, and 31 imaging in-service nurses in a third-level hospital were selected for questionnaire survey. SPSS 21.0 software was used to analyze the consultation results.Results:Through 2 rounds of consultation, the evaluation index system for core competence of nurses in the imaging department was formed, including 5 first-level indicators, 18 second-level indicators, and 78 third-level indicators. The effective response rates of the two rounds of expert consultation were 100%, and the authority coefficients were 0.933 and 0.923. In the second round, the expert opinion coordination coefficients of the first, second and third grade indexes were 0.46, 0.53 and 0.47, respectively ( P < 0.01). The core competence scores of the 31 respondents ranged from 3.08 to 4.45 in each dimension. Conclusion:After 2 rounds of expert consultation, the expert opinions tended to be consistent and the degree of coordination was high. The constructed indicators can be used for the core competence training and teaching evaluation of in-service nurses in the imaging department.
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The medical massive open online course (MOOC) quality certification standard is the reference for the implementation of medical MOOC quality monitoring. This thesis utilizes data mining, quantitative analysis, qualitative analysis and other methods, taking the comment text of the Chinese medicine courses on the Ai Course (MOOC of China Universities) platform as the data source out of which to extract certain potential indicators for the medical MOOC quality certification standard. Based on the analysis of the existing research results on MOOC quality evaluation domestic and abroad as well as the relevant policies of the Ministry of Education, a medical MOOC quality accreditation standard including 6 first-level indicators are formed, including course content, teaching design and so on. Expert scores and AHP method were used to calculate the weight coefficient of the quality certification standard. Finally, this paper explains the procedure of medical MOOC quality certification in college. This certification system can be used to conduct self-assessment and quality monitoring of medical MOOC in colleges and universities.
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Objective:To explore the causes and feelings of delayed experience of seeking medical treatment in patients with advanced lung cancer, and to provide new insights for more targeted health education and medical care services.Methods:A semi-structured in depth interview based on the theory of planned behavior was conducted among 30 patients with advanced lung cancer who experienced medical delay from November to December in 2021 admitted to First Affiliated Hospital of Guangxi Medical University. The interview content was analyzed and abstracted by using Colaizzi phenomenological analysis method and Nvivo11.0 software.Results:The delay duration of 30 patients with advanced lung cancer ranged from 90 to 213 days. Four subject groups were extracted by generic analysis: the cause of delay, the cause to seek medical help, the worry about the disease, and solutions.Conclusions:The delay behavior of patients with advanced lung cancer is affected by external situational factors such as symptom severity, family economic capacity, social support, accessibility of health services, prevalence of novel coronavirus, and subjective psychological factors such as sense of stigma and burden of disease, it is necessary to reduce the occurrence of medical delay in patients with advanced lung cancer through the comprehensive management strategy of multiple channels.
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Objective:To analyze the medication rules in the ancient book Pu Ji Fang for the external treatment of acne based on data mining method. Methods:By screening out the methods of treating acne externally in Pu Ji Fang and establishing a standardized medical record database, this paper adopted the web version of Ancient and Modern Medical Record Cloud Platform to calculate the frequency, properties, flavors, and meridians of those medicines, and conduct cluster analysis by using IBM SPSS Modeler 18.0 software to analyze the association rules. Results:A total of 87 prescriptions were selected, including 164 kinds of Chinese materia medica, among which. Radix Angelicae, Ligusticum Wallichii, Rhizoma Typhoni and lead powder are frequently appeared. The properties of those medicines are mainly warm, cold and mild; the flavors of those medicines are mainly spicy, acrid, sweet and bitter, and the meridians mainly belongs to lung, spleen, stomach and liver meridians. The medical pair and group with the strongest associationion are Ligusticum Wallichii- Radix Angelicae and Rhizoma Typhonii- Radix Angelicae- Ligusticum Wallichii. Those freuently appeared medicines could be grouped into three categories. The paste dosage that was frequently appeared has strong correlation with tallow, mercury and lead powder, while the powder dosage that was frequenctly appeared has strong correlation with Angelica Dahurica, Radix Saponicae, Gleditsia sinensis, Radices Ligustici Sinensis and Ligusticum Wallichii. Conclusions:The application of data mining method could preliminarily reveal the medication rules of Pu Ji Fang for the external treatment of acne. The main treatment method is XinSanFaYue. The three categories of Chinese materia medica are used to treat the syndrome of asthenic habitus attacked by exogenous pathogenic factors, exterior attacked by wind heat and hot blood stasis respectively, showing the rules of treating acne externally before Ming Dynasty and providing references for the clinical treatment of acne.
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This paper summarized LI Yuanwen's clinical experience in treating children with atopic dermatitis. It is considered that the core pathogenesis of children's atopic dermatitis is liver constraint and spleen deficiency， for which the main treatment methods are soothing the liver and fortifying the spleen， regulating blood and extinguishing wind， and self-made Jiawei Guomin Decoction （加味过敏煎） can be used. In clinical practice， children with atopic dermatitis are mainly divided into six types including heart fire hyperactivity， blood heat and exuberant toxin， damp pathogen congestion， disharmony of spleen and stomach， blood deficiency and wind-dryness， and yang deficiency and blood stasis. Jiawei Guomin Decoction with modifications in accordance with differentiated syndromes is recommended together with external used Qingshi Zhiyang Ointment （青石止痒软膏）.
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BACKGROUND@#The benefits of healthy lifestyles are well recognized. However, the extent to which improving unhealthy lifestyles reduces cardiovascular disease (CVD) risk needs to be discussed. We evaluated the impact of lifestyle improvement on CVD incidence using data from the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China).@*METHODS@#A total of 12,588 participants free of CVD were followed up for three visits after the baseline examination. Changes in four lifestyle factors (LFs) (smoking, diet, physical activity, and alcohol consumption) were assessed through questionnaires from the baseline to the first follow-up visit. Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). The risk advancement periods (RAPs: the age difference between exposed and unexposed participants reaching the same incident CVD risk) and population-attributable risk percentage (PAR%) were also calculated.@*RESULTS@#A total of 909 incident CVD cases occurred over a median follow-up of 11.14 years. Compared with maintaining 0-1 healthy LFs, maintaining 3-4 healthy LFs was associated with a 40% risk reduction of incident CVD (HR = 0.60, 95% CI: 0.45-0.79) and delayed CVD risk by 6.31 years (RAP: -6.31 [-9.92, -2.70] years). The PAR% of maintaining 3-4 unhealthy LFs was 22.0% compared to maintaining 0-1 unhealthy LFs. Besides, compared with maintaining two healthy LFs, improving healthy LFs from 2 to 3-4 was associated with a 23% lower risk of CVD (HR = 0.77, 95% CI: 0.60-0.98).@*CONCLUSIONS@#Long-term sustenance of healthy lifestyles or improving unhealthy lifestyles can reduce and delay CVD risk.
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OBJECTIVE@#Agar dilution method (ADM) was used as the golden standard to evaluate the consistency of Epsilometer test (E-test) in detecting the sensitivity of Helicobacter pylori (H. pylori) to metronidazole.@*METHODS@#From August 2018 to July 2020, patients with H. pylori infection treated for the first time in Peking University Third Hospital for gastroscopy due to dyspepsia were included in this study. Gastric mucosas were taken from the patients with H. pylori infection. H. pylori culture was performed. Both the ADM and E-test were applied to the antibiotic susceptibility of H. pylori to metro-nidazole, and the consistency and correlation between the two methods were validated.@*RESULTS@#In the study, 105 clinical isolates of H. pylori were successfully cultured, and the minimum inhibitory concentration ≥ 8 mg/L was defined as drug resistance. Both ADM and the E-test showed high resistance rates to metronidazole, 64.8% and 62.9%, respectively. Among them, 66 drug-resistant strains were detected by ADM and E-test, and 37 were sensitive strains, so the consistency rate was 98.1%. Two strains were evaluated as drug resistance by ADM, but sensitive by the E-test, with a very major error rate of 1.9%. There was zero strain sensitive according to ADM but assessed as resistant by the E-test, so the major error rate was 0%. Taking ADM as the gold standard, the sensitivity of E-test in the detection of metronidazole susceptibility was 97.1% (95%CI: 0.888-0.995), and the specificity was 100% (95%CI: 0.883-1.000). Cohen's kappa analysis showed substantial agreement, and kappa coefficient was 0.959 (95%CI: 0.902-1.016, P < 0.001). Spearmans correlation analysis confirmed this correlation was significant (r=0.807, P < 0.001). The consistency evaluation of Bland-Altman method indicated that it was good, and there was no measured value outside the consistency interval. In this study, cost analysis, including materials and labor, showed a 32.2% higher cost per analyte for ADM as compared with the E-test (356.6 yuan vs. 269.8 yuan).@*CONCLUSION@#The susceptibility test of H. pylori to metronidazole by E-test presents better agreement with ADM. Because it is less expensive, less labor intensive, and more rapid, it is an easy and reliable method for H. pylori susceptibility testing.
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Humanos , Metronidazol/uso terapéutico , Helicobacter pylori , Agar/uso terapéutico , Pruebas Antimicrobianas de Difusión por Disco , Pruebas de Sensibilidad Microbiana , Infecciones por Helicobacter/tratamiento farmacológico , Antibacterianos/uso terapéuticoRESUMEN
The molecular genetic characteristics of a family with rare -88 C>G (HBB: c.-138 C>G) β-thalassemia gene mutation were studied using cohort study. The cohort study was conducted from June to August 2022 by Prenatal Diagnosis Center of Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center. The phenotype and genotype were analyzed by hematological cytoanalyzer, automatic electrophoretic analysis system, and next-generation sequencing (NGS). And then, Sanger sequencing was used to verify the rare gene results. The results showed that the proband, her father, her uncle and her younger male cousin had discrete microcytosis (MCV 70.1 fl, 71.9 fl, 73.1 fl and 76.6 fl, respectively) and hypochromia (MCH 21.5 pg,22.0 pg,22.6 pg and 23.5 pg, respectively), elevated hemoglobin A2 level (5.3%, 5.4%, 5.4% and 5.5%, respectively), slightly elevated or normal fetal hemoglobin (Hb F), but no anemia. The proband was identified to have co-inherited ɑ-thalassemia (Hb Westmead gene heterozygous mutation, ɑwsɑ/ɑɑ) and β-thalassemia with a rare -88 C>G (HBB: c.-138 C>G) heterozygous mutation (β-88 C>G/βN). Her mother had the same α-thalassemia as the proband. Her father, her uncle and her younger male cousin had the same rare -88 C>G heterozygous mutations as the proband. While her grandmother and younger brother were not carrier of thalassemia. In conclusion, 4 cases of rare -88 C>G(HBB:c.-138 C>G) heterozygous mutation had been detected in a Chinese family. Carriers of this beta-thalassemia are clinically asymptomatic. This study enriches the knowledge of the thalassemia mutation spectrum in Chinese people and provides valuable information for genetic counseling, prenatal diagnosis, and prevention of thalassemia, providing a scientific basis for improving the quality of birth population and preventing birth defects.
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Femenino , Humanos , Masculino , Talasemia alfa/genética , Globinas beta/genética , Talasemia beta/diagnóstico , China , Estudios de Cohortes , Genotipo , Biología Molecular , MutaciónRESUMEN
Objective To explore the correlation between serum creatinine, blood urea nitrogen content and uric acid level in adult nephrotie syndrome (AS) patients of different ages, in order to provide a theoretical basis for the prevention and control of uric acid metabolism. Methods Individuals of different ages who were diagnosed with nephrotic syndrome from March 2018 to August 2020 in the outpatient department of our hospital were selected as research subjects by stratified random sampling,healthy individuals who underwent physical examination during the same period were selected as controls .The age range of the subjects was 18-55 years old. The biochemical test results of serum creatinine, blood urea nitrogen and uric acid were retrospectively collected from patients of different ages. Pearson correlation analysis of adult serum creatinine, blood urea nitrogen and uric acid levels. Results The levels of creatinine and blood urea nitrogen in healthy adults showed an upward trend at the age of 18-40, and reached a plateau at the age of 40; while the level of uric acid showed an upward trend with age. The levels of serum creatinine, blood urea nitrogen and uric acid in AS patients at different ages were higher than those in healthy controls, and the increase was most pronounced between the ages of 45 and 55. The t-test results showed that the serum creatinine, blood urea nitrogen and uric acid contents of healthy controls were different from those of AS patients except for the 18-22 age group. The main performance was that AS patients had higher measured values than healthy controls. Pearson correlation was used to analyze the correlation between serum creatinine and blood urea nitrogen levels and uric acid in AS patients of different ages. The results showed that the 41-45-year-old patients had the strongest correlation with uric acid, r was 0.584; The patients' blood urea nitrogen level had the strongest correlation with uric acid, with r of 0.373. The age groups with the correlation between serum creatinine, blood urea nitrogen and uric acid content in AS patients were stratified according to gender. There was a significant positive correlation (r>0.45, P0.30, P<0.05). Conclusion The expression level of serum creatinine in 34-45 years old patients with nephrotic syndrome can effectively predict the level of uric acid, and the predictive value of women is higher than that of men.
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OBJECTIVE@#To explore the genetic etiology of a child with D bifunctional protein deficiency (DBPD) born to a consanguineous pedigree.@*METHODS@#A child with DBPD who was admitted to the First Affiliated Hospital of Hainan Medical College on January 6, 2022 due to hypotonia and global developmental delay was selected as the study subject. Clinical data of her pedigree members were collected. Peripheral blood samples of the child, her parents and elder sisters were collected and subjected to whole exome sequencing. Candidate variant was validated by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The child, a 2-year-and-9-month-old female, had featured hypotonia, growth retardation, unstable head lift, and sensorineural deafness. Serum long-chain fatty acids were elevated, and auditory brainstem evoked potentials had failed to elicit V waves in both ears with 90 dBnHL stimulation. Brain MRI revealed thinning of corpus callosum and white matter hypoplasia. The child's parents were secondary cousins. Their elder daughter had a normal phenotype and no clinical symptoms related to DBPD. Elder son had frequent convulsions, hypotonia and feeding difficulties after birth, and had died one and a half month later. Genetic testing revealed that the child had harbored homozygous c.483G>T (p.Gln161His) variants of the HSD17B4 gene, for which both of her parents and elder sisters were carriers. Based on the guidelines from the American College of Medical Genetics and Genomics, the c.483G>T (p.Gln161His) was rated as a pathogenic variant (PM1+PM2_Supporting+PP1+PP3+PP4).@*CONCLUSION@#The homozygous c.483G>T (p.Gln161His) variants of the HSD17B4 gene caused by the consanguineous marriage probably underlay the DBPD in this child.