RÉSUMÉ
Objective To explore the clinical application of ultrasound-guided transabdominal villus and amniocentesis in the prenatal diagnosis of thalassemia,and to find a suitable method for the prenatal diagnosis of thalassemia in Qinzhou.Methods A total of 531 high-risk pregnant women with severe or intermediate thalassemia during single pregnancy who were treated in the Department of Medical Genetics and Prenatal Diagnosis,Qinzhou Maternal and Child Health Hospital from March 2021 to April 2022 were selected for the study.According to different sampling methods,they were divided into control group(amniocentesis,n=415)and study group(transabdominal villus puncture,n=116).The success rate,complication rate of the two groups were compared.Results The success rate of puncture in the control group was 100％,2 cases were aborted within 2 weeks after surgery,17 cases were diagnosed with severe alpha-thalassemia,10 cases with severe β-thalassemia and 64 cases with intermediate thalassemia,48 cases with moderate and severe thalassemia induced labor.The success rate of puncture in the research group was 100％,10 cases were diagnosed with severe alpha-thalassemia,4 cases with severe β-thalassemia and 17 cases with intermediate thalassemia,and 26 cases with moderate severe thalassemia were induced labor.There was no significant difference in puncture success rate and abortion rate between the two methods(P>0.05).Conclusion Both methods are safe and effective.Transabdominal villus sampling can detect fetal thalassemia in early pregnancy,and it is worth promoting and applying in clinical practice.
RÉSUMÉ
OBJECTIVE：To evaluate the safety of PARP inhibitors in hematological system ，and to provide evidence-based evidence for rational drug use in the clinic. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library ，ScienceDirect， CNKI，CBM，VIP and Wanfang data from May 2014 to June 2019，randomized controlled trials （RCTs）about PARP inhibitors or PARP inhibitors combined with chemical treatment drugs （trial group ）versus chemical treatment drugs alone ，placebo alone or chemical treatment drugs combined with placebo （control group ）were collected. After literature screening ，data extraction and quality evaluation with bias risk assessment tool recommended by Cochrane systematic evaluator manual 5.1.0，and Meta-analysis was performed by using Rev Man 5.3 software，and sensitivity analysis and publication bias analysis. RESULTS ：A total of 10 RCTs were included ，involving 3 129 patients. Meta-analysis showed that the incidence of anemia ≥grade 3 [RR＝7.27，95％CI （2.74，19.27），P＜0.000 1]，neutropenia≥grade 3 [RR＝2.46，95％CI（1.43，4.24），P＝0.001]，and leukopenia ≥grade 3 in trial group [RR ＝1.71，95％CI（1.15，2.54），P＝0.008] in trial group were significantly higher than control group. There was no statistically significant difference in the incidence of thrombocytopenia ≥grade 3 between two groups [RR ＝3.54，95％CI（0.66， 19.05），P＝0.14]. Results of sub-group analysis showed that the incidence of an emia≥grade 3 and neutropenia ≥grade 3 in the patients receiving PARP inhibitors alone ，PARP inhibitors combined with chemical treatment dr ugs as well as the incidence of leukopenia≥grade 3 in the patients receiving PARP inhibitors （No.2018FH001-096） combined with chemical treatment drugs were significantly higher than those receiving placebo alone ，chemical treatment com drugs alone or chemical treatment drugs combined with placebo （P＜0.05）. Sensitivity analysis supported the above results howerer，publication bias was possibility. CONCLUSIONS ：PARP inhibitor in the treatment of cancer can cause hematological system adverse drug reaction ，mainly manifesting as anemia ，neutropenia and leukopenia. These results should be interpreted with caution.
RÉSUMÉ
Objective To evaluate the value of ultrasound elastography combined with serum markers in the assessment of chronic hepatitis B fibrosis. Methods 100 patients with chronic hepatitis B liver fibrosis who were diagnosed and treated in our hospital from January 2015 to December 2017 were randomly selected. All patients were given hepatic histopathological tests, serological tests, and ultrasound elastography. The liver biopsy results were taken as the final diagnosis results. The accuracy of classification of hepatitis B fibrosis by the combined diagnosis of ultrasound elastography and serum markers was observed. Results The total accuracy of the combined examination was 91.00％ with histological examination as the final results. There was no statistically significant difference between the results of the two examinations (P>0.05). The ultrasound elastography score and FIB4 score in the patients with hepatitis B fibrosis grade F1-F4 were increased along with the increase of grade, and there was statistically significant difference (P<0.05). Conclusion Ultrasound elastography combined with serum markers has an important clinical value in the assessment of the degree of chronic hepatitis B fibrosis. It is non-invasive, easy to operate and highly accurate, and can provide a reliable basis for disease diagnosis and staging.
RÉSUMÉ
Objective To explore the feasibility of intelligent spatiotemporal image correlation-fetal heart navigator(iSTIC-FHN) in the display of the ductal arch view in normal fetuses ,and to compare two-dimensional echocardiography( 2DE) and iSTIC-FHN based measures of ductus arteriosus( DA ) in normal fetuses . Methods Two hundred and eleven normal fetuses with gestational age of 22 - 32 weeks were enrolled . Each fetus had undergone conventional 2DE examination and the iSTIC fetal cardiac volumes were obtained .The volume datasets were analyzed offline using new automatic software ( the Fetal Heart Navigator ,FHN ) . The diameter of DA were measured by 2DE and iSTIC based FHN ,respectively . Pearson's correlation analysis was used to examine the relation between gestational age and diameter of DA for both 2DE and iSTIC-FHN . The measurement of the diameters of ductus arteriosus by two methods were compared . Results The ductal arch view using FHN was successfully obtained in 165(78 .2％ ) cases among 211 normal cases . The comparison of 2DE and iSTIC-FHN in the measurement of the DA was made in 131(62 .1％ ) normal fetuses . Mean 2DE DA increased from ( 3 .00 ± 0 .23) mm at 22 weeks to ( 5 .42 ± 0 .26) mm at 32 weeks . Mean iSTIC-FHN DA increased from ( 2 .96 ± 0 .21) mm at 22 weeks to ( 5 .36 ± 0 .17) mm at 32 weeks . There was a good correlation between the two methods ( Pearson's R 2 = 0 .942 ,P =0 .539) . Bland-Altman plot showed the 95％ limits of agreement was ( - 0 .3287 ,0 .3111) . Conclusions iSTIC-FHN is the potential tool for the evaluation of the ductal arch view .
RÉSUMÉ
Objective To evaluate the diagnostic value of different detecting technologies in antinuclear an-tibody(ANA)in autoimmune diseases(AID).Methods A total of 52 cases of patients with systemic lupus er-ythematosus(SLE),97cases of patients with AID but without SLE,92 cases of patients without immune disea-ses were collected in this study.ANA was detected by enzyme-linked immunosorbent assay(ELISA),indirect immunofluorescence(IIFA)method and linear western blot method(LIA).Results Average coincidence rate between ELISA and IIFA method to detect the ANA was 78.8% in the three groups of participants.The re-sult of ANA detected by ELISA method was positively correlated with that of IIFA method(r=0.598,P<0.05).They found that patients with AID and without AID groups both existed the phenomenon of IIFA ANA+LIA ANA -,their fluorescence titers were given priority to with 1:100.Their fluorescence modes were given priority to with granularity in both AID group(67.44%)and without AID group(54.69%),there was no difference between the two groups(P>0.05),but they were significantly higher than that of other flu-orescence modes.At the same time,the study found that patients with IIFA ANA -LIA ANA+were mostly AID patients(73.3%),the ratio was higher than without AID group,among these patients,AID patients were with SSA/Ro60,SSA/Ro52,SSB/La as the main positive autoantibodies,rather than without AID patients with anti-Sm,SSA/Ro52,SSB/La,CenpB as the main positive antibodies.Conclusion It should pay attention to multi-index joint and multi-tests detection when we diagnose autoimmune diseases.
RÉSUMÉ
Objective To determine the prevalence of fatigue among taxi drivers in Kunming city,to better understand their general working and health conditions,and to determine the risk factors associated with fatigued driving.Methods A total of 400 taxi drivers were randomly selected for participation in a self-administered questionnaire survey,which included height and weight measurements.The response rate was 88.3％.The survey consisted of four main categories:personal particulars,social habits,work patterns and sleep profile.The Epworth Sleepiness Scale was used to estimate the level of daytime sleepiness and fatigue.Multiple logistic regression analysis was used to estimate the adjusted odd ratios and 95％ confidence interval associated with risk factors related to fatigue among taxi drivers.Results A high proportion of taxi drivers were obese and had self-reported hypertension,diabetes mellitus and high cholesterol.Driver fatigue was associated with very poor/poor self-rating of quality of sleep,having an additional part-time job,and driving more than 10 hours a day.Conclusion The findings of the present study will improve awareness of the work and health conditions of taxi drivers,and contribute toward efforts to achieve a healthier workforce.A lower prevalence of fatigued driving may lead to lower risks of road traffic accidents,lower economic loss,higher productivity,and safer roads for all.
RÉSUMÉ
Objective To evaluate the concordance of two-dimensional echocardiography (2DE) and intelligent spatiotemporal image correlation (iSTIC) in measuring fetal aortic and aortic arch diameters during the second and third trimesters.Methods Data were collected by a prospective cross-sectional study of 140 normal singleton fetuses with the gestational age from 22 to 32 weeks.A total of 6 dimensions of the fetal aortic and aortic arch,including aortic annular diameter (AO),ascending aorta diameter (AAO),aortic arch diameter [AO Arch (INA to LCCA)],aortic arch diameter [AO Arch (LCCA to LSA)],aortic isthmus diameter and descending aorta diameter (DAO),were measured by two different methods.Concordance was assessed by comparing the measurements acquired by iSTIC with those determined by 2DE and depicted by Bland-Altman plots.Inter-and intra-observer variability was evaluated by the intraclass correlation coefficient (ICC) test.Results A total of 137 iSTIC volumes in 140 cases were found to be suitable for further analysis.Good correlation was observed in the measurements that determined by 2D or iSTIC (Pearson's R2 =0.977-0.983).There was no significant difference in the mean values of all the parameters that measured by two methods.Bland-Altman plot showed that the 95％ limits of agreement (LOA) in AO,AAO,AO Arch (INA to LCCA),AO Arch (LCCA to LSA),aortic isthmus diameter and DAO were (-0.1260/+ 0.2299),(-0.1707/+ 0.2241),(-0.1547/+ 0.2190),(-0.1736/+ 0.2024),(-0.1514/+ 0.2039) and (-0.1485/+ 0.2228),respectively.The points in the outside of LOA were 5.11％ (7/137),4.38％ (6/137),5.11％ (7/137),5.84％ (8/137),4.38％ (6/137)and 4.38％ (6/137),respectively.Conclusions iSTIC has a good agreement with 2DE in measuring fetal aortic and aortic arch dimensions during the second and third trimesters.
RÉSUMÉ
Objective To evaluate right atrial function in patients with idiopathic dilated cardiomyopathy (IDCM) and ischemic cardiomyopathy (ICM) by using two-dimensional speckle tracking imaging (2D-STI).Methods Study population consisted of 31 patients with IDCM,30 with ICM and 30 healthy subjects.High frame rate two-dimensional images were recorded from the apical four chamber view.Right atrial global longitudinal strain (GLS) was measured using two-dimensional strain soft ware.Results Compared with the controls,left ventricular ejection fraction (LVEF),tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (RVFAC),right ventricular fractional shortening (RVFS) and tricuspid annular peak systolic velocity(S') decreased (P ＜0.05),while right ventricular myocardial performance index (MPI) increased in IDCM and ICM group.There were no significant differences for all above echocardiographic parameters between IDCM and ICM patients.Compared with the controls,right atrial GLS decreased significantly in patients with IDCM and ICM,even much lower in patients with IDCM (P ＜0.001).Conclusions Measurement of right atrial strain using 2DSTI could be used for the assessment of right atrial dysfunction in patients with ICDM and ICM.
RÉSUMÉ
Objective To analyse clinical application of hepatitis B virus core antibody(HBcAb)detected by using the chemilu-minescence microparticle immunoassay.Methods A total of 1 6 830 specimen with positive HBcAb detected by using the two pairs of semi-hepatitis test from January 2012 to November 2014 were collected,and divided into three groups according to the cut off in-dex(COI)of detection results of HBcAb,including group 1.0-0.05).The detec-tion rate of HBsAg(+)HBsAb(-)of group 9.0-<1 1.0 was significantly lower than that of the other two groups(P <0.05).A total of 304 specimen were HBsAg(-)HBsAb(-)and COI≥1 1,among them 64 specimen were HBV DNA postive and the posi-tive rate was 21.0%.Conclusion In the detection of HBcAb,COI≥1 1 and 1.0-<9.0 could be reference indicators for diagnosiing current and past HBV infection respectively,which should be combined with other laboratory indicators of HBV clinical data for comprehensive analysis.
RÉSUMÉ
Objective To analyze reason and countermeasures of unqualified blood specimens ,improve the qualified rate of sam-ples ,to strengthen the quality control before analysis .Methods A retrospective statistical analysis were conducted to analyze the characteristics of the unqualified specimen and reasons from January 2013 to June 2014 .Results A total of 11 024 unqualified spec-imens accepted in the inspection center from January 2013 to June 2014 ,accounting for 0 .331% of reasons of unqualified specimens including hemolysis(26 .7% ) ,blood coagulation(25 .8% ) .The unqualified specimen in surgical system was higher than that in med-ical system .Conclusion Control specimen qualified rate system should be established in clinical laboratory ,the fraction defective samples should be reduced through continuous analysis and communication with clinical medical personnel to ensure the quality be-fore analyzing .
RÉSUMÉ
Objective To evaluate the short-term effect of open and laparoscopic cholecystectomy surgery on body.Methods Forty patients with cholecystectomy were divided into open surgery group and laparoscopic surgery group by random digits table method with 20 cases each.The clinical index was compared between two groups.The immunoglobulin G(IgG) and procalcitonin (PCT) before surgery and 4 d after surgery were determined.Results The operative blood loss,anal exhaust time,length of stay was (135.80 ±26.74) ml,(1.6 ±0.9) h,(6.7 ±3.2) d in open surgery group,which was better than that in laparoscopic surgery group [(63.41 ± 15.06) ml,(0.4 ± 0.3) h,(2.8 ± 1.9) d],and there was significant difference (P ＜ 0.05).The incidence of heat was 15％(3/20) in open surgery group,which was higher than that in laparoscopic surgery group (0),and there was significant difference (P ＜0.05).There was no significant difference in the IgG and PCT between two groups before surgery (P ＞ 0.05).The IgG and PCT at 4 d after surgery was (13.93 ± 1.98) g/L,(2 153.2 ± 1 452.1) mg/L in open surgery group,which was higher than that in laparoscopic surgery group[(9.23 ± 2.87) g/L,(768.0 ± 237.0) mg/L],and there was significant difference (P ＜ 0.05).Condmion Laparoscopic cholecystectomy has smaller short-term effects on body,while the body of the humoral and cellular immune function in mild,conducive to the body's recovery.
RÉSUMÉ
Objective To study the situation of missing detection of HBsAg negative samples with high value and to explore the ways for reducing the missing detection .Methods According to the document EP15-A2 issued by the Clinical and Laboratory Standards Institute(CLSI) ,the precision and accuracy of the HBsAg quantitative detection by the ARCHITECT I 2000 were verified for ensuring the instrument conditions conforming to the test requirements .The 1 130 samples with the ratio of the sample absor-bance value to critical value(S/CO) in the range 0 .30-0 .99 in the HBsAg qualitative results by ELISA were collected during the study period and re-tested .After re-testing ,the quantitative HbsAg of 387 samples ,in which the ratio of S/CO was still in the range 0 .30-0 .99 ,were detected by the ARCHITECT I2000 and the detection results were taken as the reference .The missing detection situation of HBsAg negative samples with high value was researched .The ROC curve was adopted to reassess the cutoff value of negative HBsAg with positive HbcAb for searching better diagnostic performance .Results The HBsAg detection results by the i2000SR had good repeatability with total imprecision of less than 9 .88% and the deviation value with calibrator was less than 3 .91% ,which conformed to the clinical testing requirements .This study found that the HBsAg samples with the S/CO ratio of 0 .30-0 .99 had the significant distribution differences in the different batches of test (P<0 .05) .In the study period ,261 cases of HBsAg missing detection occurred ;then the critical value of HBsAg qualitative results detected by ELISA in the HbcAb positive group was re-determined as 0 .51 by using the ROC curve ,among them 239 cases were rejudged as positive .Conclusion Increasing the repeatability of HBsAg qualitative detection by ELISA and establishing the new positive judgement value of ELISA for qualita-tive HBsAg in the HbcAb positive population as 0 .51 possesses better diagnostic performance for detection the HBsAg samples with the S/CO ratio of 0 .30-0 .99 .
RÉSUMÉ
Objective To retrospectively analyze the clinical characteristics ,pathological features and aetiology of pulmonary carcinoid tumourlets .Methods The clinical data of 10 patients with pulmonary carcinoid tumourlets in the West China Hospital of Sichuan University from April 1976 to October 2013 were collected for conducting the retrospective analysis and combining the lite‐raute review .Results Of the total 10 patients ,3 cases were male and 7 cases are female .9 cases were accompanied by bronchiecta‐sis ,1 case was complicated with lung adenocarcinoma .The clinical manifestations were lack of specificity ,which were dominated by repeated cough ,expectoration ,dyspnea and hemoptysis .The microscopic pathological examination suggested that there were differ‐ent degrees of inflammation reaction or fibrous tissue hyperplasia .All patients had no carcinoid syndrome ,lymph node and distant metastasis .10 cases received the surgical treatment .6 cases were pulmonary hypoplasia ,in which 1 case was carcinoid tumourlets complicating pulmonary sequestration .The postoperative follow up lasted for 5 - 80 months .8 cases had no recurrence and 2 cases were loss of follow up .Conclusion For the middle‐aged women patients with bronchiectasis and poor therapeutic effect ,complica‐ting carcinoid tumourlets should be vigilant ,active surgery combined with the pathologic examination is a suitable clinical decision .