The application value of GeneXpert MTB/RIF Ultra in the detection of special specimens of tuberculosis / 中国热带医学

@#Abstract: Objective To compare the diagnostic efficacy of the upgraded version of the GeneXpert automated fluorescent quantitative PCR system (GeneXpert MTB/RIF Ultra, GeneXpert Ultra) and the original version of the GeneXpert system (GeneXpert MTB/RIF, Xpert), real-time fluorescent quantitative nucleic acid detection (FQ-PCR), real-time fluorescent thermostatic amplification of Mycobacterium tuberculosis RNA (SAT-RNA), real-time fluorescent thermostatic amplification detection of DNA (thermostatic amplification method) and traditional BACTEC MGIT 960 liquid culture (culture method) for special specimens of tuberculosis, in order to analyze its application value in clinical detection. Methods Using prospective research methods, a total of 170 special specimens (including 47 pleural and ascites effusion samples, and 34 24-hour urinary sediment specimens, 49 tissue specimens and 40 fester specimens) were collected i'an Chest Hospital from January to September 2021. GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were used for detection. Clinical diagnosis was used as the standard, and sensitivity, specificity, positive predictive value, negative predictive value, coincidence rate, and Kappa value were compared among the methods. Results The sensitivities of GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were 65.18% (73/112), 49.11% (55/112), 37.50% (42/112), 19.64% (22/112), 8.04% (9/112), and 22.32% (25/112), respectively. The sensitivity of GeneXpert Ultra was higher than that of the other five methods, and the differences were statistically significant (χ2=66.25, 42.10, 28.89, 13.09, 4.92, 15.18, all P<0.05). GeneXpert Ultra result analysis showed that: 5.48%(4/73) cases had trace, that is, trace Mycobacterium tuberculosis load, 79.45% (58/73) cases were extremely low, 10.96% (8/73) cases were low, 2.74% (2/73) were medium, , and 1.36% (1/73) were high load. In 4 trace samples, the Xpert detection was negative for all. Of the 73 GeneXpert Ultra positive reports, 63 were rifampicin-sensitive, 6 were rifampicin-resistant, and 4 were rifampicin-resistant but of unclear resistance. Of the 55 Xpert positive reports, 45 were rifampicin-sensitive, 2 were rifampicin-resistant, and 8 were rifampicinresistant but of unclear resistance.. Conclusions The new generation of GeneXpert MTB/RIF Ultra has high sensitivity, specificity and drug resistance detection rate, and its advantage is even more apparent in the pathogenic diagnosis of special specimens of tuberculosis. It can be used as one of the preferred methods in samples with low bacterial load.

Achievements in molecular markers for prognosis evaluation of nasopharyngeal carcinoma / 中国肿瘤生物治疗杂志

@#]复发和转移是影响鼻咽癌患者预后和生存质量的主要原因。目前临床上主要使用基于解剖学的TNM分期标准，并不能 准确反映患者的预后情况，因此需要开发新的更为精准的鼻咽癌预后判断标准。通过对鼻咽癌发病机制的研究，分子标志物在 鼻咽癌预后过程的预测价值日益引起关注。本文总结了近年来在鼻咽癌增殖、生存和侵袭转移等方面的研究进展，以及在这些 研究过程中发现的相关分子标志物和它们在临床预后评估中的作用，综合分析这些分子标志物差异性表达与临床患者生存之间 的相关性，证明了这些分子标志物在评估患者预后中的潜在价值。随着对鼻咽癌发病机制研究的深入，将会发现更多有价值的 分子标志物，这为建立更为精准的鼻咽癌预后评估方法提供了可能。

Transposition of Branches of Radial Nerve Innervating Supinator to Posterior Interosseous Nerve for Functional Reconstruction of Finger and Thumb Extension in 4 Patients with Middle and Lower Trunk Root Avulsion Injuries of Brachial Plexus / 华中科技大学学报（医学）（英德文版）

This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus.From April 2010 to January 2015,we enrolled in this study 4 patients diagnosed with middle and lower trunk root avulsion injuries of the brachial plexus via imaging tests,electrophysiological examinations,and clinical confirmation.Muscular branches of the radial nerve,which innervate the supinator in the forearm,were transposed to the posterior interosseous nerve to reconstruct the thumb and finger extension function.Electrophysiological findings and muscle strength of the extensor pollicis longus and extensor digitorum communis,as well as the distance between the thumb tip and index finger tip,were monitored.All patients were followed up for 24 to 30 months,with an average of 27.5 months.Motor unit potentials (MUP) of the extensor digitorum communis appeared at an average of 3.8 months,while MUP of the extensor pollicis longus appeared at an average of 7 months.Compound muscle action potential (CMAP) appeared at an average of 9 months in the extensor digitorum communis,and 12 months in the extensor pollicis longus.Furthermore,the muscle strength of the extensor pollicis longus and extensor digitorum communis both reached grade Ⅲ at 21 months.Lastly,the average distance between the thumb tip and index finger tip was 8.8 cm at 21 months.In conclusion,for patients with middle and lower trunk injuries of the brachial plexus,transposition of the muscular branches of the radial nerve innervating the supinator to the posterior interosseous nerve for the reconstruction of thumb and finger extension function is practicable and feasible.

Analysis on missing items of questionnaire of identification for TCM constitution responded by 1322 residents in community / 国际中医中药杂志

ObjectiveTo study the missing items in questionnaire cfidentification for TCM constitution.MethodsThe questionnaires were regarded as study objects,which were independently finished by 1322 participants in Changfeng community who were over 45 years and agreed to participate in.The data'was analyzed by SPSS.ResultsMissing items were found in the questionnaires,with a missing rate of 33.74％ on an overall basis.No statistic difference was noted between male and female (x2=0.67,P＞0.05).The rate of missing items increased as participants' age climbing up to the age of 80,and then decreased.Groups characterized with age and gender showed difference in missing items.89.69％ of the incomplete questionnaires had less than 3 missing items,which concentrated in some specific items.ConclusionAttention should be addressed to the fact that missing items were found in questionnaircs of identification for TCM constitution finished independently by residents.

Imaging manifestation and clinical value in herniation pit of femoral neck / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the imaging manifestation and clinical value in herniation pit of femoral neck.</p><p><b>METHODS</b>One case proved by operation and pathology and twenty cases with typical imaging manifestation described by Pitt were reviewed retrospectively. There were 17 males and 4 females with an average age of 53 years old(ranging from 30 to 85 years). All cases were examined by X-ray films and CT, and 13 cases were performed with MRI.</p><p><b>RESULTS</b>Twenty-nine lesions were found in the 21 cases, 9 cases were in right side, 8 cases were in left side, 4 cases were in both sides. The lesions were all located in the superior lateral part of the femoral neck and anterior lateral base of femoral head. The lesions were round or oval, and most of their greatest diameter was less than 16 mm. X-ray films showed a central radiolucency with a thin clear sclerotic rim or simple sclerotic loop. CT scans showed a well-defined lesion of soft-tissue attenuation with sclerotic margin. The lesions had focal cortical perforation. On MRI images,most lesions showed uniformly long T1 and long T2 fluid signal intensity.</p><p><b>CONCLUSION</b>Herniation pit of femoral neck have some specific imaging features, CT can make accurate diagnosis. X-ray and MRI are helpful to diagnosis.</p>