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Objective:To investigate the application value of ultrasound-guided multimodal examinations in the diagnosis of lymph node mycobacterial infection.Methods:The clinical data of 42 patients with suspected lymph node mycobacterial infection who were initially diagnosed at the Affiliated Hospital of Shaoxing University from January 2019 to December 2020 were retrospectively analyzed. All patients underwent an ultrasound-guided lymph node-negative pressure puncture. Acid-fast staining, bacterial culture, pathological examination or their combination were used to screen lymph nodes for mycobacterial infection. The results were compared with those of acid-fast staining and bacterial culture of sputum and bronchoalveolar lavage fluid smears.Results:The combined application of acid fast staining, bacterial culture, and pathological examination for the puncture fluid smear showed a positive rate of 71.4% (30/42), which was significantly higher than the positive rate [26.2% (11/42)] for acid fast staining of the puncture fluid smear, the positive rate [42.9% (18/42)] for bacterial culture of the puncture fluid, and the positive rate [50.0% (21/42)] of pathological examination ( χ2 = 17.20, 7.00, 4.04, P < 0.001, P < 0.01, P = 0.040). The positive rate for sputum smear and bacterial culture was 21.4% (9/33). The positive rate for acid fast staining and bacterial culture of the bronchoalveolar lavage fluid was 28.6% (12/30). The differences were statistically significant ( χ2 = 21.11, 15.43, both P < 0.001). Conclusion:Ultrasound-guided negative pressure aspiration and puncture biopsy of lymph nodes combined with acid fast staining, bacterial culture, and pathological examinations can markedly increase the detection rate and diagnostic rate of mycobacterial infection.
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ObjectiveTo investigate the clinical features of patients with Caroli disease. MethodsThe clinical data were collected from 41 patients who were diagnosed with Caroli disease in The Fifth Medical Center of Chinese PLA General Hospital from April 2015 to January 2020, and the patients were divided into type I group with 16 patients and type Ⅱ group with 25 patients. A retrospective analysis was performed for general information, laboratory markers, and clinical features. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data; a Spearman correlation analysis was also performed. ResultsThe type Ⅰ group had a significantly higher level of albumin (Alb) than the type Ⅱ group (t=0.976, P=0.048), and the type Ⅱ group had a significantly higher prothrombin time (PT) than the type I group (Z=3.115, P=0.001). Compared with the type I group, the type Ⅱ group had significantly higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (χ2=6.077, 5.468, and 2.403, P=0.002, 0.019, and 0.028). In the patients with type Ⅱ Caroli disease, the level of cholinesterase was negatively correlated with the incidence rates of esophageal and gastric varices and portal hypertension (r=-0.468 and -0.436, P=0.018 and 0.029); Alb level was negatively correlated with the incidence rate of esophageal and gastric varices (r=-0.561, P=0.004); red blood cell count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.662, -0.566, and -0.436, P＜0.001, P=0.003, and P=0.029); hemoglobin count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.605, -0.590, and -0.510, P=0.001, 0.002, and 0.009); PT was positively correlated with the incidence rates of esophageal varices and portal hypertension (r=0.488 and 0.520, P=0.013 and 0.008). ConclusionCompared with the patients with type I Caroli disease, the patients with type Ⅱ Caroli disease have a higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension, with the changes in clinical indicators such as the decrease of Alb level and the increase of PT level, and they tend to have poor prognosis.
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Objective To explore the relationship between stone formation and histopathological characters of renal papilla in patients with infectious renal calculi. Methods A total of 43 patients with infectious renal calculi undergoing percutaneous nephrolithotomy (PCNL) were included in this study. Renal papilla biopsy specimens were obtained under a nephroscope during the operation, fol-lowed by staining with hematoxylin-eosin or alizarin bordeaux for light microscopy and electron mi-croscopy. The extracted stones were analyzed and proved to be composed of magnesium ammonium phosphate or carbonate apatite with a transform-infrared spectrometer. Results Renal papilla calci-um plaques were found in 24 of the 43 patients (56 % ) during PCNL. Local calcium salt deposits could be found localized in the renal tubular basement membrane and spread to the interstitial tissue. Tiny stone adherence was observed in the renal papillae where calcium salts grew into the collection system. Conclusion Calcium salt deposits exist on the renal papilla in some patients with infectious renal calculi, which may be correlated with the formation of infectious stones.
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0.05). CONCLUSION The secar of oropharynx can be regarded as a predictive index for OSAHS severity and guideline for operation, but the change of secar after operation can not be used as a predicitive index for therapeutic effectiveness.
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OBJECTIVE This objective of this study was to investigate intranasal anatomic abnormalities in cases of contact point headaches caused by contact between the nasal septum and the lateral nasal wall,as well as the clinical outcomes in these cases treated by endoscopic sinonasal surgery. METHODS A retrospective review was performed on 58 cases that met the criteria of having contact points between the septum and the lateral nasal wall, as demonstrated by CT scans of the sinuses and endoscopic examinations. These patients underwent surgical intervention in order to correct the contact points. They were re-evaluated for clinical parameters three months after the surgical correction of their anatomic abnormalities. RESULTS Abnormal nasal septa, enlarged turbinates and other anatomic abnormalities were the most common findings in contact point headaches. Fifty-eight patients underwent surgical correction of intranasal anatomic abnormalities. After follow-up periods of 3-18 mouths, 32 patients were cured, 23 were relieved to an extent, and 3 did not benefit. A significant decrease in the severity and frequency of headaches was noted after surgery. CONCLUSION Pressure from mucosal contact between the septum and lateral nasal wall mucosa is the key cause of contact point headaches, as seen in CT scans of the sinuses and endoscopic examinations. Clinically significant pain may improve after surgical correction of intranasal anatomic abnormalities.
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OBJECTIVE To explore the methods and effects of endoscopic nasal structure reshaping for treatment of chronic rhinosinusitis(CRS). METHODS One hundred and twenty-three cases of CRS patients with abnormal anatomy in nasal cavity and sinus were treated by the Messerklinger approach. At the same time varieties of anatomical abnormalities were corrected,including:①submucous resection of nasal septum,②submusous middle turbinate resection,③submusous inferior turbinate resection,④Uncinate process resection ⑤deal with frontal recess and its adjacent cells. RESULTS All patients were followedup for 1 to 2 years. One hundred and six cases were successful,14 satisfied and 3 inefficient. The rate of full recovery was 97.56%. CONCLUSION Reshaping nasal structure during endoscopic surgery is a method worth recommendation for structural rhinitis.
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OBJECTIVE To observe the submucosal infiltrating extent of laryngeal carcinoma tissue by different location,different T staging and external appearance and to analyze the impact of laryngeal carcinoma submucosal infiltrating extent on surgical margin.METHODS Forty-three laryngeal en bloc specimens coming from 43 cases with laryngeal carcinoma were vertically cut-down along tumor long axis,and were slivered into sections by which laryngeal carcinoma submucosal infiltrating distance was measured under microscope.Laryngeal carcinoma latent submucosal infiltrating extent was compared among different location,different T staging and external appearance.RESULTS Basing on tumor external appearance and infiltrating extent,laryngeal carcinoma was classified into three types:exogenic type,ulcerating infiltrating type and mixed infiltrating type.Of 43 specimens,the three types were 10,8 and 25 cases respectively.There was a significant difference in submucosal infiltrating extent between T1～T2 and T3～T4 laryngeal carcinoma.There was also significant difference in submucosal infiltrating extent between exogenic type and ulcerating infiltrating type or mixed infiltrating type.CONCLUSION The submucosal infiltrating extent of laryngeal carcinoma tissue plays an important role in the surgical margin. As laryngeal carcinoma T stage developing,tumor submucosal infiltrating extent is becoming more extensive.Laryngeal carcinoma submucosal infiltrating extents in ulcerating infiltrating and mixed infiltrating type are more extensive than that in exogenic type.The partial laryngectomy should be prudent to be performed in cases with local advanced ulcerating infiltrating and mixed infiltrating laryngeal carcinoma.