Résumé
Objective:To investigate the current status of diagnosis and treatment of Helicobacter pylori ( H. pylori) infection in primary hospitals in Jiangsu Province, and to evaluate the capability of comprehensive prevention and management of H. pylori infection in the primary hospitals. Methods:From 2020 to 2022, a questionnaire survey was conducted among 430 primary hospitals, which participated in the Incubation Center Project of Primary Gastroenterology Specialty Department in Jiangsu Province. The questionnaire survey includedthe establishmment of endoscopy and department of gastroenterology, items of H. pylori detection, H. pylori treatment, eradication plans and treatment course. The questionnaire was filled by the director of the primary hospital. Descriptive analysis was used for statistical analysis. Results:A total of 413 valid questionnaires were received. Among the 413 primary hospitals, 286 (69.2%) were equipped with endoscopy centers, and 202 (48.9%) had departments of gastroenterology. In terms of diagnostic methods for H. pylori, 35.8% (148/413) of the primary hospitals did not have urea breath test equipment, of which 84 hospitals did not carry out any H. pylori testing items, 8 hospitals only had rapid urease test, 45 hospitals only had serum H. pylori antibody test, 7 hospitals had both rapid urease test and serum H. pylori antibody test, and 4 hospitals had fecal H. pylori antigen test. In terms of therapeutic drugs, all the hospitals could provide proton pump inhibitors, and 82.8% (342/413) of the hospitals had bismuth agents. According to diagnosis and treatment guideline for H. pylori infection at the primary care, 7 combinations of two antibiotics were recommended. A total of 14 (3.4%) hospitals could provide all the combinations, 369 (89.3%)hospitals could provide 2 to 6 combinations, 20(4.8%)hospitals could provide only one combination, and 10 (2.4%) hospitals could not provide any combination. For the selection of the eradication scheme and treatment course, the bismuth-based quadruple scheme was chosen in 248 (60.0%) hospitals, 14-day course was selected in 363(87.9%) hospitals, and 14-day course of bismuth-based quadruple scheme was selected in 232 (56.2%) hospitals. Conclusion:Improving the H. pylori testing equipment in primary hospitals, preparing all types of therapeutic drugs, and improving doctors′ knowledge of diagnosis and treatment of H. pylori in are of great significance for improving the prevention and treatment efficacy of H. pylori infection at the primary hospitals.
Résumé
【Objective】 To retrospectively analyze the guiding significance and effect of thromboelogram (TEG) in the clinical use of cryoprecipitation. 【Methods】 A total of 289 patients with fibrinogen reduction, admitted to our hospital between January 2018 and December 2021, were collected. They was divided into control group (using coagulation examination and clinical feature as the transfusion criteria) and observation group (above parameters plus TEG). The TEG index in the observation group before and after transfusion and Fg, APTT, PT, and TT in 2 groups of patients before and after transfusion were monitored. The efficacy and prognosis of different blood products and cryoprecipitate were compared between 2 groups of patients.) 【Results】 The efficacy of choprecipitate transfusion was better in the observation group than the control[Fg index after transfusion (g / L) 1.92±0.92 vs 1.80±1.00, P<0.05]. And less blood products were used in observation group as compared with the control[ RBC(U) 1.93±2.69 vs 2.81±3.25 (P<0.05); FFP(mL) 667±378 vs 879±455(P<0.05)]. No differences were noticed by hospital stay between the two groups, but the prognosis in the observed group was significantly better than that in the control. 【Conclusion】 It’s scientific and reasonable to apply TEG to guide the clinical transfusion of cryoprecipitate, so as to save blood resources and improve the prognosis.
Résumé
【Objective】 To retrospectively analyze the clinical effects of apheresis and concentrated platelets under different transfusion strategies, so as to explore more scientific transfusion strategies. 【Methods】 A total of 279 patients with thrombocytopenia, admitted to our hospital during January 2020 and October 2021, were collected.They was divided into group A(apheresis platelet transfusion alone), group B(concentrated platelet transfusion alone), and group C(both apheresis and concentrated platelet transfusion). Platelet count of three groups were measured 24 hours before and after transfusion and their CCI values were calculated and compared to understand the differences in transfusion efficiency and adverse reactions, as well as the efficacy among three groups with different blood groups. 【Results】 Patients, received solo apheresis platelets, demonstrated a lower incidence of transfusion refractoriness and adverse reactions, but also a lower treatment efficacy(14.63±13.48)(P<0.05). However, the treatment efficacy of patients, received solo concentrated apheresis, could reach 16.00±21.77, but presented a higher incidence of transfusion refractoriness and adverse reactions. Patients, received both apheresis and concentrated platelets, maintained a good treatment efficacy(16.21±16.33), with a low incidence of transfusion refractoriness and adverse reactions.At the same time, different blood types also affect the treatment efficacy of platelet transfusion. 【Conclusion】 The simultaneous transfusion of apheresis and concentrated platelets contributes to the effective treatment of patients and lower incidence of adverse reactions.
Résumé
Objective:To analyze the clinical characteristics of patients with different types of coronavirus disease 2019 (COVID-19).Methods:A total of 272 eligible COVID-19 patients who were admitted to Guangzhou Eighth People′s Hospital, Guangzhou Medical University from January 22 to February 15, 2020 were retrospectively enrolled. General characteristics, the first laboratory examination and imaging data of these patients were collected. According to the clinical classification, there were 236 cases in non-severe group (mild+ common type) and 36 cases in severe group (severe+ critical type). Comparisons between groups were performed by t test, chi-square test or rank-sum test when appropriate. Results:There were 23 males and 13 females in the severe group, 103 males and 133 females in the non-severe group, and the difference was statistically significant ( χ2=5.149, P=0.023). The age of severe group was (60.5±11.2) years, which was higher than that of non-severe group (46.8±15.7) years. The difference was statistically significant ( t=6.43, P<0.01). The lymphocyte (LYM) count, platelet (PLT) count and arterial partial pressure of oxygen (PaO 2) in the severe group were 0.90(0.55, 1.10)×10 9/L, 170.00(143.50, 198.00)×10 9/L and 73.50(69.70, 83.00) mmHg(1 mmHg=0.133 kPa), respectively, which were all lower than those in the non-severe group (1.42(1.09, 1.95)×10 9/L, 187.00(148.00, 230.00)×10 9/L and 96.00(83.20, 108.00) mmHg, respectively). The differences were all statistically significant ( Z=5.59, 2.00 and 5.00, respectively, all P<0.05). The levels of creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), C reaction protein (CRP) and procalcitonin (PCT) in the severe group were 123.00(79.00, 212.00) U/L, 32.10(27.00, 47.40) U/L, 305.50(216.00, 396.00) U/L, 37.02(23.92, 63.66) mg/L and 0.09(0.05, 0.19) μg/L, respectively, which were all higher than those in the non-severe group (68.00(48.00, 103.00) U/L, 20.10(16.70, 26.20) U/L, 179.00(150.00, 222.00) U/L, 26.55(18.11, 36.96) mg/L and 0.04(0.03, 0.06) μg/L respectively), and the differences were all statistically significant ( Z=3.89, 5.60, 5.12, 2.85 and 5.43, respectively, all P<0.01). No significant differences were observed in white blood cell count, creatine kinase isoenzyme and blood lactate between the two groups ( Z=1.53, 0.41 and 1.00, respectively, all P>0.05). Conclusion:Gender, age, LYM count, PLT count, PaO 2, CK, AST, LDH, CRP and PCT could be used to provide reference for clinical classification of COVID-19 patients.
Résumé
Objective To investigate the risk factors for non-curative resection after endoscopic submucosal dissection ( ESD ) for early esophageal cancer and high-grade intraepithelial neoplasia .Methods The clinicopathological data of 427 cases of early esophageal cancer and high-grade intraepithelial neoplasia who underwent ESD was performed from January 2013 to December 2016 in the Department of Gastroenterology , First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed .According to the results of postoperative pathology and immunohistochemistry ,339 patients were defined as curative resection group and 88 patients were defined as non-curative resection group .Chi-square test , univariate analysis and multivariate logistic regression analysis were used for statistical analysis .Results A total of 427 patients were enrolled in this study, with an average age of (63.2 ±7.7) years, including 96 cases of early esophageal cancer and 331 cases of high-grade intraepithelial neoplasia .The enbloc resection rate of ESD was 94.8％(405/427), 88 of them were non-curative resected, and the non-curative resection rate was 20.6％.Univariate analysis showed that early esophageal cancer (odds ratio (OR)=3.682, 95％confidence interval (CI) 2.216 to 6.118, P<0.01), submucosal infiltration (OR=10.220, 95％CI 4.861 to 21.481, P<0.01), ESD indications (OR=6.005, 95％CI 3.545 to 10.172, P<0.01) and lifting sign after injecting at the base of lesions (OR=2.508, 95％CI 1.005 to 6.255, P=0.042) were statistically significant between non-curative resection group and curative resection group . Multivariate unconditional logistic regression analysis revealed that submucosal infiltration (OR =4.329, 95％CI 1.758 to 10.661,P =0.001), not absolute indications of ESD (OR =6.484, 95％CI 2.205 to 19.068, P=0.001) and negative lifting sign (OR=3.182, 95％CI 1.171 to 8.651, P=0.023) were independent risk factors for non-curative resection.Conclusions Patients with early esophageal cancer , submucosal infiltration , not absolute indications for ESD and negative lifting signs are prone to non-curative resection .Moreover , submucosal infiltration , not absolute indications for ESD , and negative lifting signs are the independent risk factors for non-curative resection .
Résumé
Helicobacter pylori (Hp) has been confirmed to be associated with a variety of gastrointestinal tract and extra-gastrointestinal diseases. The eradication rate of classic triple therapy regimen was reduced gradually in recent years, and it was shown that antibiotic resistance and irregular treatment were the main causes of the failure of eradication. The choice of treatment should be based on the local antibiotic resistance situation, if necessary, individual sensitivity tests should be considered. At the same time, the in-depth study on mechanisms of drug resistance is helpful to decrease the eradication failure and reduce the drug resistance. This article reviewed the advances in study on antibiotic resistance of Hp.
Résumé
OBJECTIVE@#To explore the genetic basis for a Chinese pedigree where three siblings were affected with Parkinson's disease.@*METHODS@#Multiple ligation-dependent probe amplification (MLPA) and next-generation sequencing (NGS) were employed to detect the causative mutation. Sanger sequencing of cDNA was also used for verify the effect of mutation on the transcription of RNA.@*RESULTS@#Heterozygous deletion of exon 3 of the PARK2 gene was detected by MLPA, while a heterozygous splice site variant c.619-3G>C was detected by NGS. Both mutations were shown to result in aberrant transcripts of the PARK2 gene (loss of exons 3 and 6, respectively) by Sanger sequencing of cDNA. Both mutations have co-segregated with the disease in the pedigree.@*CONCLUSION@#Compound heterozygous mutations of the PARK2 gene probably underlie the disease in this pedigree. Identification of the splice site variant c.619-3G>C has expanded the mutation spectrum of the PARK2 gene.
Sujets)
Humains , Asiatiques , Chine , Analyse de mutations d'ADN , Exons , Hétérozygote , Mutation , Maladie de Parkinson , Génétique , Pedigree , Ubiquitin-protein ligases , GénétiqueRésumé
A method was developed for determination of 12 kinds of phosphate compounds in water and sediment by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) coupled with solid phase extraction (SPE) and ultrasonic extraction.The water samples were concentrated by HLB solid-phase extraction (SPE) column and eluted twice with ethyl acetate, ultrasonic solvent extraction for sediment samples and then repeated the operation of water samples after diluted with deionized water.The sample were separated on a ZORBAX Eclipse Plus C18 (150 mm × 2.1 mm, 3.5 μm) column by a gradient elution with 0.2% formic acid aqueous solution and methanol as the mobile phase.Ion mode analysis was monitored by high performance liquid chromatography mass spectrometer (MRM).The target compounds were quantified by external standard method.At the spiked levels (0.05, 0.1 and 0.5 μg/L), the average recoveries of 12 kinds of OPEs in water samples ranged from 66.4% to 115%, except for TMP (28.5%-47.8%) and TEHP (22.4%-73.8%).The relative standard deviation RSD (n=3) was 0.5%-9.09%, and the method quantification (MOQ) was 0.001-0.05 μg/L, However at the spiked levels of 5, 10 and 50 μg/kg, the average recoveries of 12 kinds of OPEs in sediment samples ranged from 65.4% to 120.0%, except for TMP (35.7%-44.9%) and TCEP (31.2%-48.9%).The relative standard deviation RSD (n=3) was 0.01%-9.54%, and the MOQ for sediment was 0.02-2.0 μg/kg dw.Based on the above methods, the detection and analysis of the targets in the water and sediments samples of Taihu Lake were carried out.The results showed that the concentrations of ΣOPEs were 0.1-1.7 μg/L and 8.1-420 μg/(kg dw), respectively.
Résumé
This report presents a case of dentinogenesis imperfecta type Ⅲ with supernumerary teeth,the etiopathogenesis,clinical manifestations and therapy are discussed.
Résumé
Objective To observe the influence of clopidogrel combined with proton pump inhibitor(PPI) on the incidence rate of in-stent restenosis (ISR) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention(PCI).Methods The clinical data of 132 ACS patients who were taking clopidogrel antiplatelet therapy were retrospectively analyzed.The control group (single clopidogrel) and observation group (clopidogrel +PPI) had 66 cases in each group.The incidence rate of ISR was compared between the two groups.Results The factor of gender,age,history of smoking,high blood pressure,heart function insufficiency,diabetes,peripheral vascular disease,oral medications,and the number of implanted stents in the two groups of patients with ACS may affect ISR factors constitute had no statistical significance (all P ＞ 0.05) ; ISR incidence rate of the observation group and the control group was 19.7％ and 9.1％,the difference was statistically significant (x2 =4.880,P ＜ 0.05).Conclusion PPI combined with clopidogrel could significantly increase ISR incidence rate of patients after PCI during follow up period of (12.0 ± 4.2)months,which should be carefully used in patients after PCI.
Résumé
0.01). The new caries did not occur in the test group. DMF index was higher in the controls than that in the tested subjects(P
Résumé
Objective To explore the changing regularity of humeral distal epiphysial anteverted angulation with ultrasonic measurement. Methods Using an ultrasonic diagnostic apparatus with a high frequency bougie to detect the dextral elbow joint of 203 normal individuals whose age range is from 5 d to 23 years old. The subjects were divided into 5 groups by age (5 d-4 years old, 5-8 years old, 9-12 years old, 13-16 years old, ≥17 years old),and by sex into two large parts.Anteverted angulation of capitellum and lateral semitrochlear ossification center were measured with statistic analysis and correlation calculation.Results Anteverted angulation of capitellum was 48.89?? 8.96?, lateral semitrochlea 33.70?? 7.18?. Anteverted angulation of capitellum enlarges with age growth, and it reaches the climax ( 55.00?? 5.88?) at the age 13-16 years old. There was a significant difference among groups. After 17 years old, anteverted angulation slightly reduces to 52.38?? 8.27?, compared with the climax ( 55.00?? 5.88?), there was no statistical difference. Changing regularity of anteverted angulation was similar to that of capitellum. Just between the 5 d-4 years old group and 5-8 years old group, the difference was significant in angulation enlargement. There was no statistical difference among the groups above the 5-8 years old group, and no significant difference between male and female in humeral distal epiphysial anteverted angulation. Conclusions Ultrasonic examination can clearly display the images of humeral distal epiphysis. Observation and measurement is available for the epiphysial anteverted angulation by acoustic images, and the changing regularity of anteverted angulation can be illustrated.