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Objective To compare the value of ultrasound-guided fine-needle aspiration (FNA) and core needle biopsy (CNB) in diagnosing benign and malignant cervical lymph nodes.Methods A retrospective analysis was performed on 88 patients who received biopsy for cervical lymph node enlargement from January 2015 to May 2017.FNA (n =39) or CNB (n =49) were performed respectively to compare the sensitivity,specificity and accuracy of the two methods in diagnosing benign and malignant cervical lymph node enlargement.Results 84.6％ (33/39) of FNA cases were successfully collected,and 98％ (48/49) of FNA cases were successfully collected for definite pathological diagnosis (P =0.000).The sensitivity,specificity and accuracy of FNA and CNB in diagnosing malignant cervical lymph nodes were 90.9％ and 97.2％,94.1％ and 100％,92.3％ and 98％,respectively.Compared with FNA,there were statistically significant differences in sensitivity,specificity and accuracy in differentiating benign and malignant lymphatic lesions in cervical enlargement (P ＜0.01).The sensitivity and specificity of FNA and CNB in diagnosing cervical lymph node metastatic carcinoma were 100％ and 100％,95.2％ and 100％.Compared with FNA,there was no statistically significant difference in the sensitivity to the diagnosis of cervical lymph node metastatic carcinoma (P =0.102).Conclusions CNB is superior to FNA in sensitivity,specificity and accuracy in diagnosing cervical lymphadenopathy.However,when metastatic cancer was diagnosed,FNA was not significantly different from CNB in sensitivity (P =0.102),and FNA was recommended as the first choice.
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Objective To establish the normal reference range for serum folate of healthy children in Guangzhou region.Methods Levels of serum folate of 1 860 healthy children (1 061 males and 799 females) and 129 adults (52 males and 77 females) living in Guangzhou region were examined by LK3000V Vitamin Analyzer.Then the data were analyzed with statistical methods.Results ①There was no statistical difference between boys and girls for levels of serum folate in every group defined by age (P＞0.05).②The levels of serum folate [median(P2.5,P97.5)] defined by age were as follows:9.39 (6.12,14.85) nmol/L for 0～1 year-old group,10.65 (6.05,16.52) nmol/L for 1.01～17 year-old group and 11.12 (6.3,17.51) nmol/L for the adult group.Statistical difference was found between any two groups of the three (P＜0.05).③No statistical correlation was found between age and the level of serum folate (r=0.039,P=0.09).Conclusion Reference range for serum folate for healthy children in Guangzhou region include two parts:6.12～ 14.85 nmol/L for 0～ 1 year-old group and 6.05～～16.52 nmol/L for 1.01～17 year-old group.
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Objective To explore the infection rate of hepadnaviruses and non-hepatotropic virus in infants with biliary atresia(BA)and their relationship between the onset and development of BA.Methods The data and pathogen test records from 184 BA infants who were hospitalized at Guangzhou Women and Children's Medical Center from January 1,2010 to December 31,2014 were reviewed,and the infection rates caused by 3 hepadnaviruses including hepatitis A virus(HAV),hepatitis B virus(HBV),hepatitis E virus(HEV)as well as 5 non-hepatotropic viruses including cytomegalovirus(CMV),Epstein-Barr virus(EBV),herpes simplex virus(HSV),enterovirus(EV),Coxsackie-virus were analyzed.The outpatients or inpatients without BA and immunodeficiency were selected as controls.Results In BA patients,the infection rates of CMV were highest(40.21％,39/97 cases)caused by 3 hepadnaviruses(HAV,HBV,HEV)and 5 non-hepatotropic viruses(CMV,EBV,HSV,EV,Cox),while the infection rates of HAV,HEV,HBV,EBV,HSV,EV or Coxsackievirus were all low,and mixed virus infection was found in 9 patients.The positive rate of CMV IgM in BA group[34.94％(29/83 cases)] was significantly higher than that in the control group[15.69％(8/51 cases)],and the difference was statistically significant(x2=5.86,P0.05).No statistical difference in age was found in BA patients on detection between the positive and the negative group,and the consistency of CMV DNA and CMV IgM was not ideal(Kappa value<0.4).Conclusions Infection of CMV is quite common in BA patients,BA infants under 60 days old show higher detection rate of CMV DNA than the older ones,but there is no difference in detection rate of CMV IgM among different ages,CMV is not supported as a secondary infection and may play a role in the occurrence and development of BA.
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Objective To investigate the recheck rule by investigating the coincidence rate of the results detected by the LabU‐Mat urine dry chemistry analyzer and the Urised tangible composition analyzer with the results detected by the microscope examina‐tion .Methods 1 040 urine specimens from children outpatients and children inpatients were collected .Firstly ,the specimens were analyzed by the LabUMat urine dry chemistry analyzer and the Urised tangible composition analyzer ,and then detected by using the microscopic examination for investigating the recheck rule of the routine analysis by the urine automatic analyzer ;the regulation was evaluated by the missed detection rate ,and then the recheck rule avoiding the missed diagnosis of abnormal renal function was also evaluated .Finally ,clinically verify the rules adopting 200 specimens to perform the clinical verification on this recheck rule .Results Among the specimens used for researching the recheck rule ,the specimens of positive microscope examination results accounted for 58 .65% ,the specimens of negative results accounted for 41 .35% .In the positive detection specimens ,the specimens of RBC positive were the majority ,accounting for 50% ,the specimens of WBC positive accounted for 23 .08% and the specimens of CAST positive accounted for 7 .69% .The coincidence rate of the set rule was 87 .5% and the missed detection rate was 2 .9% .In conduc‐ting the verification on the recheck rule by 200 urine specimens ,the coincidence rate was 89 .52% and the missed detection rate was 2 .4% .Conclusion When the detection results of occult blood(BLD) ,WBC(LEU) and protein(PRO) by the dry chemistry analyzer and the detection results of RBC ,WBC ,CAST by the tangible composition analyzer are inconsistent or the differences among them are beyond 2 grades of differential ,the recheck by the microscopic examination should be performed .
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Objective To study the values of glycosylated hemoglobin in screening for patients with prediabetic state in Guang-zhou region .Methods 525 Guangzhou people who had accepted health examination were enrolled and were subjected to oral glucose tolerance test(OGTT) .BIO-RAD D-10 automatic glycosylated hemoglobin analyzer was employed to detect their glycosylated he-moglobin A1c(GHbA1c) .OGTT results were served as diagnostic criteria ,Receiver operator characteristic (ROC) curve analysis was performed to obtain the optimal threshold of GHbA1c in diagnosing impaired glucose regulation (IGR) .Results The optimal threshold of GHbA1c in diagnosing IGR was 5 .95% .The sensitivities of GHbA1c≥5 .95% and GHbA1c≥5 .7% in diagnosing IGR were 53 .3% and 84 .8% ,respectively ,while their specificities were 72 .8% and 31 .0% ,respectively .The difference of sensitivity between GHbA1c≥5 .95% combined with FPG≥5 .6 mmol/L and GHbA1c≥5 .7% alone in diagnosing IGR showed no statistical significance(P= 0 .406) ,while the specificity increased obviously (P= 0 .000) .Conclusion The criteria of GHbA1c≥5 .7% can be used for prediabetic state screening but not for diagnosis .GHbA1c≥5 .95% combined with FPG≥5 .6 mmol/L can be used effectively for prediabetic state screening in Guangzhou people .
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OBJECTIVE To investigate the clinical character and risk factor of nosocomial lower respiratory tract(infection)(NLRTI) due to Burkholderia cepacia in intensive care units(ICU) and discuss how to control infection.METHODS The clinical data of 37 cases were reviewed and analyzed,and 43 cases with non-B.cepacia NLRTI served as control group.RESULTS The difference in ICU stay time,mechanical ventilation,bronchoscopy,H_2-receptor blocker/antacid,use of antibiotics≥2 kinds and vein catheter between patients with and without B.cepacia(NLRTI) was statistically significant.CONCLUSIONS ICU stay time,mechanical ventilation,bronchoscopy,(H_2-receptor) blocker/antacid,use of antibiotics≥2 kinds and vein catheter are risk factors of B.cepacia NLRTI.Susceptibility of antibiotics to B.cepacia showed multidrug resistance to which should be paid attention in ICU,respiratory tract invasive operation limitation,medical facility sterilization and rational use of antibiotics are very important.