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Objective:To investigate the efficacy of metagenomic next generation sequencing (mNGS) in the etiological diagnosis of patients with spinal infection, so as to provide reference for timely diagnosis and treatment.Methods:A total of 40 patients with suspected spinal infection admitted to the Department of Infectious Diseases in Henan Provincial People′s Hospital from January 2020 to July 2022 were included. The results of tissue culture, histopathological examination and tissue mNGS detection were analyzed retrospectively. According to the clinical diagnose, the patients were divided into the spinal infection group (28 cases) and the non-spinal infection group (12 cases). The positive rate, sensitivity and specificity of mNGS and tissue culture in the pathogen detection of patients with spinal infection were compared. McNemar test was used for statistical analysis.Results:There were 23 males and 17 females in 40 patients. The positive rate of mNGS was higher than that of tissue culture (75.0%(30/40) vs 12.5%(5/40)), and the difference was statistically significant ( χ2=0.08, P<0.001). Based on clinical diagnostic criteria, the sensitivity of mNGS in the diagnosis of spinal infection was higher than that of tissue culture (82.1% vs 17.9%), with a statistically significant difference ( χ2=0.02, P<0.001), while the specificity compared to the tissue culture (33.3% vs 100.0%), the difference was not statistically significant ( P>0.05). Conclusions:mNGS has a high pathogen detection rate and sensitivity in the etiological diagnosis of patients with spinal infection, which could provide clinical guidance for the diagnosis and treatment of patients with spinal infection.
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Objective To investigate the clinical outcome of Ellman grade Ⅲ bursal-side partial-thickness rotator cuff tears(b-PT-RCT)treated by the arthroscopic single-row technique with articular tendon fibers reservation.Methods A retrospective study was conducted on 31 patients with Ellman grade Ⅲ (b-PT-RCT) who underwent arthroscopic rotator cuff repair (RCR) with the single-row technique in our hospital between January 2014 and October 2016.The intact articular side tissue of the rotator cuff was reserved in 17 patients of group A,and was resected to convert to a full-thickness cuff tear in 14 patients of group B.The visual analog pain scale(VAS)score,Constant-Murley score and shoulder active range of motion(ROM),and magnetic resonance imaging(MRI)results were compared between the two groups during the last follow-up.Results Among the 31 patients,25 were followed,with 14 in group A followed for an average of 16.29(12～25)months and 11 of group B followed for an average of 15.37(12～27)months.There were no significant differences between the two groups in all measurements before the intervention and at the last follow-up.After the operation,significant improvement was observed in all planes of the active ROM for both groups(P＜0.05).The VAS score of group A and B decreased significantly from 6.50 ± 1.16 and 6.63 ± 1.80 before the operation to 0.86 ± 0.57 and 0.91 ± 0.63 at the last follow-up(P＜0.05 for both).However,the average Constant-Murley score improved significantly from 55.21 ± 6.40 to 86.85 ± 4.85 in Group A(P＜0.05),while from 54.37 ± 6.30 to 85.73 ± 5.36 in group B(P＜0.05).During the last follow-up,no retear occurred in both groups according to the MRI examination.Conclusion The outcome of single-row repair for grade Ⅲ bursal-sided partial-thickness rotator cuff tears with either articular tendon preservation or converting of the lesion to a full-thickness tear is satisfying.No significant differences were found in their clinical outcomes.
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ObjectiveTo investigate the genotypes and resistance loci in patients with chronic hepatitis B(CHB) achieving virologic breakthrough in the treatment with lamivudine (LAM) combined with adefovir (ADV) after developing drug resistance in the treatment with LAM alone. MethodsA total of 89 CHB patients who were admitted to Henan Provincial People′s Hospital and treated with LAM and ADV as the antiviral therapy after developing drug resistance in the treatment with LAM alone from June 2010 to June 2013 were enrolled, and their serum samples were collected. Quantitative real-time PCR was used for hepatitis B virus (HBV) detection, and sequencing was applied to determine the genotype and detect the resistance loci rtN236T, rtA181V, rtM204V, and rtL180M. The t-test was applied for comparison of continuous data between groups, and the chi-square test was applied for comparison of categorical data between groups. ResultsLAM rtM204V mutation was detected in all the 89 patients after treatment with LAM alone. After the combination therapy with LAM and ADV, ADV rtN236T mutation was detected in 9 patients, ADV rtA181V mutation in 5 patients, and rtN236T+rtA181V mutation in 8 patients, with an overall ADV resistance rate of 24.7% (22/89). As for HBV genotyping, 82 patients had genotype C, and rtA181V+rtN236T mutation was detected in 8 patients; 7 patients had genotype B. ConclusionCompared with the patients with HBV genotype B, the patients with genotype C are more susceptible to rtA181V+rtN236T mutation during the combination therapy with LAM and ADV after developing drug resistance in the treatment with LAM alone.