Clinicopathological features of twenty four active aortitis cases / 中华风湿病学杂志

Objective:To explore the clinicaland pathological characteristics of aortitisin order to improve the understanding of this rare conditionand improve correct diagnostic rate.Methods:Twenty-four cases of active aortitis were identified from a total of 1 838 cases of ascending aorta specimens in the last 6 years at Wuhan Asia General Hospital. Clinical data including medical history, laboratory and imaging data were collected and the treatment with immunosuppressive and hormonal treatment as well as follow-up data were analyzed. Pathological data including gross findings, microscopic features of the aortic valve and aorta were analyzed. Continuous variables were expressed as mean±standard deviation. Frequencies were described as percentages. Results:Among the 24 cases of active aortitis, 1 case was clinically diagnosed as aortitis before operation, 7 cases were suspected aortitis before operation, and the other 16 cases were diagnosed as aortitis after pathological examination. Among those 16 cases, one case was Behcet′s syndrome, 2 cases were infectious aortitis, 3 cases were Takayasu aortitis, and 10 cases were clinically isolated aortitis. None case had aortic stenosis, while 21 cases had aortic valve insufficiency. Eleven cases of aortitis showed coagulation necrosis. In the 5 cases of Behcet′s syndrome, 3 had acute noninfectious endocarditis of aortic valve.Conclusions:Most of the aortitis in this study was found accidentally in pathological examination. All of the clinically isolated aortitiswere misdiagnosed before pathological examination. Most of the patients with aortitis had simple aortic valve insufficiency. Coagulation necrosis is an important clue for the diagnosis of aortitis. Acute noninfectious endocarditis is an important clue for the diagnosis of Behcet′s syndrome.

Correlation between endoscopic classification and antibiotic resistance of Helicobacter pylori in 5 441 patients with benign gastric diseases / 中华消化杂志

Objective:To analyze the relationship between the gastric diseases classification under endoscopy and infection and antibiotic resistance of Helicobacter pylori ( H. pylori) based on the data of gastric diseases classification under endoscopy, H. pylori isolation and antibiotic resistance. Methods:From January 1, 2015 to December 31, 2019, endoscopic diagnosis and the data of drug susceptibility of H. pylori of 5 441 patients with benign gastric diseases along with gastrointestinal symptoms who visited The First People′s Hospital of Putuo District of Zhoushan were retrospectively collected. The H. pylori infection in patients with different genders and different types of gastric diseases and the drug resistance rates of H. pylori among different antibiotic types were analyzed. Chi-square test was used for statistical analysis. Results:The positive rate of H. pylori in 5 441 patients with benign gastric diseases was 51.37% (2 795/5 441). The drug resistance rates of clarithromycin, levofloxacin, metronidazole, amoxicillin, tetracycline and furazolidone were 26.73% (747/2 795), 43.22% (1 208/2 795), 98.68% (2 758/2 795), 0.32% (9/2 795), 0 and 0, respectively. Among the 2 795 cases of H. pylori-positive patients, only 23 cases (0.82%) were sensitive to all six antibiotics; 1 263 cases (45.19%) were resistant to single antibiotic; 1 072 cases (38.35%) were resistant to combination of two antibiotics, and 433 cases (15.49%) were resistant to combination of three antibiotics. The drug resistance rate to three antibiotics, clarithromycin, levofloxacin and metronidazole simultaneously was the highest (15.31%, 428/2 795). And only four patients (0.14%) were simultaneously resistant to four antibiotics clarithromycin, levofloxacin, metronidazole and amoxicillin. H. pylori infection rate in men was higher than that in women (55.23%, 1 615/2 924 vs. 46.88%, 1 180/2 517), and the difference was statistically significant ( χ2=37.76, P<0.01). However there were no statistically significant differences in the drug resistance rates of six antibiotics between different gender among H. pylori-positive patients (all P>0.05). There was statistically significant difference in the positive rate of H. pylori among patients with different types of gastric diseases ( χ2=909.07, P<0.01). The positive rate of H. pylori was the highest in patients with duodenal ulcer (97.53%, 79/81), and the lowest in patients with bile reflux gastritis (19.79%, 37/187). There were statistically significant differences in the drug resistance rates of metronidazole, clarithromycin, levofloxacin and amoxicillin among 9 types of gastric diseases ( χ2=24.75, 38.62, 80.54 and 7.01, all P<0.01). Conclusions:The positive rate of H. pylori and antibiotic resistance rate are different in patients with different types of gastric diseases. It is necessary to pay attention to the selection of drugs for ulcerative diseases in the process of clinical treatment. Individualized treatment is recommended according to the results of antibiotic susceptibility test.

Influence of non-diabetic hyperglycemia on postoperative complications following laparoscopic colorectal cancer resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of non-diabetic hyperglycemia on postoperative complications following laparoscopic colorectal cancer resection.</p><p><b>METHODS</b>Clinical data of 636 patients undergoing laparoscopic colorectal cancer resection in The Affiliated Nanhai Hospital of Southern Medical University between 2009 and 2013 were analyzed retrospectively. After excluding cases with diabetes mellitus, the patients were divided into the hyperglycemia group (blood glucose level>7.8 mmol/L at any time during hospitalization period, n=161) and the non-hyperglycemia group (n=309).</p><p><b>RESULTS</b>Compared to non-hyperglycemia group, hyperglycemia group had more intraoperative blood loss [(186±80) ml vs. (158±74) ml, P=0.007] and longer postoperative hospital stay [(14.0±6.8) d vs. (11.2±5.5) d, P=0.013]. The overall rate of postoperative complication was 24.8% and 16.5% respectively (P=0.030), in the hyperglycemia and the non-hyperglycemia groups, and the mortality was 1.2% and 0.6% respectively (P=0.541). Multivariable analysis showed hyperglycemia was an independent risk factor of postoperative complication (RR=2.425, 95% CI:1.210-4.226, P=0.006).</p><p><b>CONCLUSIONS</b>Non-diabetic hyperglycemia may increase the risk of postoperative complications following laparoscopic colorectal cancer resection. Perioperative blood glucose monitoring should be performed, regardless of patients with or without diabetes.</p>

Research on tumor information grid framework / 生物医学工程学杂志

In order to realize tumor disease information sharing and unified management, we utilized grid technology to make the data and software resources which distributed in various medical institutions for effective integration so that we could make the heterogeneous resources consistent and interoperable in both semantics and syntax aspects. This article describes the tumor grid framework, the type of the service being packaged in Web Service Description Language (WSDL) and extensible markup language schemas definition (XSD), the client use the serialized document to operate the distributed resources. The service objects could be built by Unified Modeling Language (UML) as middle ware to create application programming interface. All of the grid resources are registered in the index and released in the form of Web Services based on Web Services Resource Framework (WSRF). Using the system we can build a multi-center, large sample and networking tumor disease resource sharing framework to improve the level of development in medical scientific research institutions and the patient's quality of life.