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Objective To explore the value of pelvic CT angiography(CTA)digital three-dimensional reconstruction model(abbreviated as"three-dimensional model")in the diagnosis of female pelvic mass.Methods A total of 98 patients with pelvic mass who were hospitalized and operated in Xi'an People's Hos-pital(Xi'an Fourth Hospital)from January 2021 to April 2023 were selected.All patients underwent B-ultra-sound and CTA examination before operation,and the original data of CTA were collected.The digital three-dimensional model of pelvic mass was established by three-dimensional reconstruction software,and the source of pelvic mass was judged according to the blood supply of pelvic mass.Taking postoperative pathological di-agnosis as the gold standard,the coincidence rate between different preoperative diagnosis methods(B-ultra-sound,CTA examination and three-dimensional model)was compared.The receiver operating characteristic(ROC)curve was plotted to evaluate the efficacy of different preoperative diagnostic methods in judging the ovarian origin of pelvic tumors.Results A total of 130 pelvic masses were included in 98 patients,and the average maximum diameter of the mass was(71.61±3.03)mm,including 83 ovarian masses and 47 non-ovarian masses.Taking postoperative pathological diagnosis as the gold standard,the diagnostic coincidence rate of the preoperative three-dimensional model was 72.31％,which was higher than that of B-ultrasound(58.46％)and CTA(52.31％),and the differences were statistically significant(P＜0.001).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,Kappa value,and area under the ROC curve were 79.51％,91.49％,94.29％,71.67％,83.85％,0.67 and 0.855,respectively,when the three-dimensional model showed that the blood supply of the mass originated from ovarian artery or uterine artery-ovarian branch.Conclusion The three-dimensional model of pelvic CTA can directly display the blood supply source,characteristics of mass,and the relationship between mass and adjacent organs,which can guide the clinical treatment.It has certain clinical value to judge the ovarian origin of pelvic mass by using ovarian artery and uterine artery-ovarian branch.
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Objective@#This study aimed to identify the risk factors for genitourinary fistulas and delayed fistula recognition after radical hysterectomy for cervical cancer. @*Methods@#This study was a retrospective analysis of data collected in the Major Surgical complications of Cervical Cancer in China (MSCCCC) database from 2004–2016. Data on sociodemographic characteristics, clinical characteristics, and hospital characteristics were extracted. Differences in the odds of genitourinary fistula development were investigated with multivariate logistic regression analyses, and differences in the time to recognition of genitourinary fistula were assessed by Kruskal–Wallis test. @*Results@#In this study, 23,404 patients met the inclusion criteria. Surgery in a cancer center, a women’s and children’s hospital, a facility in a first-tier city, or southwest region, stage IIA, type C1 hysterectomy, laparoscopic surgery and ureteral injury were associated with a higher risk of ureterovaginal fistula (UVF) (p<0.050). Surgery in southwest region, bladder injury and laparoscopic surgery were associated with greater odds of vesicovaginal fistula (VVF) (p<0.050). Surgery at cancer centers and high-volume hospitals was associated with an increase in the median time to UVF recognition (p=0.016; p=0.005). International Federation of Gynecology and Obstetrics (FIGO) stage IIA1-IIB was associated with delayed recognition of VVF (p=0.040). @*Conclusion@#Intraoperative urinary tract injury and surgical approach were associated with differences in the development of UVFs and VVFs. Patients who underwent surgery in cancer centers and high-volume hospitals were more likely to experience delayed recognition of UVF. Patients with FIGO stage IIA1-IIB disease were more likely to experience delayed recognition of VVF.
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The National Medical Products Administration has authorized sodium oligomannate for treating mild-to-moderate Alzheimer's disease.In this study,an LC-MS/MS method was developed and validated to quantitate sodium oligomannate in different biomatrices.The plasma pharmacokinetics,tissue distri-bution,and excretion of sodium oligomannate in Sprague-Dawley rats and beagle dogs were system-atically investigated.Despite its complicated structural composition,the absorption,distribution,metabolism,and excretion profiles of the oligosaccharides in sodium oligomannate of different sizes and terminal derivatives were indiscriminate.Sodium oligomannate mainly crossed the gastrointestinal epithelium through paracellular transport following oral administration,with very low oral bioavail-ability in rats(0.6％-1.6％)and dogs(4.5％-9.3％).Absorbed sodium oligomannate mainly resided in circulating body fluids in free form with minimal distribution into erythrocytes and major tissues.So-dium oligomannate could penetrate the blood-cerebrospinal fluid(CSF)barrier of rats,showing a con-stant area under the concentration-time curve ratio(CSF/plasma)of approximately 5％.The cumulative urinary excretion of sodium oligomannate was commensurate with its oral bioavailability,supporting that excretion was predominantly renal,whereas no obvious biliary secretion was observed following a single oral dose to bile duct-cannulated rats.Moreover,only 33.7％(male)and 26.3％(female)of the oral dose were recovered in the rat excreta within 96 h following a single oral administration,suggesting that the intestinal flora may have ingested a portion of unabsorbed sodium oligomannate as a nutrient.
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AIM: To explore the antibacterial activity and underlying mechanism of ursolic acid combined with fusidic acid against Staphylococcus aureus (SA) ATCC29213 and Methicillin-Resistant Staphylococcus aureus (MRSA) ATCC43300 in vitro. METHODS: The minimum inhibitory concentration (MIC) of the combined use of ursolic acid and fusidic acid on SA, MRSA was determined by the micro broth dilution method and the micro checkerboard method, and the partial inhibitory concentration index (FICI) was calculated to determine the combined effect. And the bactericidal effect of fusidic acid combined with ursolic acid was studied by the time-killing curves. The agar double dilution method was used to determine the anti-drug resistance mutation concentration (MPC) and anti-drug resistance mutation selection window (MSW) of fusidic acid alone and in combination with ursolic acid. The viable count of biofilm carrier were determined by serial dilution method and the semi-quantitative biofilm by crystal violet staining method. RESULTS: The combined use of ursolic acid and fusidic acid for SA and MRSA FICI were 0.312 5 and 0.375, respectively. The time-killing curve showed that 1MIC ursolic acid combined with 1MIC fusidic acid has a synergistic bactericidal effect on SA and MRSA. The MPC of fusidic acid to MRSA was 256 μg/mL and the MSW was 256. After fusidic acid combined with ursolic acid, the MPC decreased to 8 μg/mL. The combined group was significantly reduced compared to the fusidic acid group. The semi-quantitative and biofilm bacterial counts of combined group were markedly decreased compared to the fusidic acid group after the biofilm cultivate for 48 h and 72 h.CONCLUSION: The combined use of UA and FA has a synergistic effect on SA and MRSA.
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Objective@#To compare 5-year disease-free survival (DFS) and overall survival (OS) rates of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for stage IB1 and tumor size <2 cm with visible or invisible tumors. @*Methods@#We retrospectively compared the oncological outcomes of 1,484 cervical cancer patients with IB1 and tumor size <2 cm on final pathology, who received ARH (n=899) or LRH (n=585) between January 2004 and December 2016. Patients were divided into visible tumor subgroup (ARH: n=668, LRH: n=444) and invisible tumor subgroup (ARH: n=231, LRH:n=141) according to tumor type. @*Results@#LRH and ARH showed similar 5-year DFS and OS rates (93.3% vs. 93.1%, p=0.997;96.2% vs. 97.5%, p=0.351) in total study population. LRH was not associated with worse 5-year DFS rate (hazard ratio [HR]=0.96; 95% confidence interval [CI]=0.58–1.58; p=0.871) or OS rate (HR=1.37; 95% CI=0.65–2.89; p=0.409) by multivariable analysis. In the visible tumor subgroups, LRH and ARH showed similar 5-year DFS and OS rates (91.9% vs. 91.9%, p=0.933; 95.0% vs. 96.9%, p=0.276), and LRH was not associated with worse 5-year DFS or OS rate (p=0.804, p=0.324). In the invisible tumor subgroups, LRH and ARH also showed similar 5-year DFS and OS rates (97.3% vs. 97.1%, p=0.815; 100% vs. 99.5%, p=0.449), and LRH was not associated with worse 5-year DFS rate (p=0.723). @*Conclusions@#Among patients with stage IB1 and tumor size <2 cm, whether the tumor is visible or not, the oncological outcomes of LRH and ARH among cervical cancer patients are comparable. This suggests that LRH may be suitable for stage IB1 and tumor size <2 cm with visible or invisible tumors.
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AimsTo explore clinical features and outcome of 2019 novel coronavirus(2019-nCoV)-infected patients with high BNP levels Methods and resultsData were collected from patients medical records, and we defined high BNP according to the plasma BNP was above > 100 pg/mL. In total,34 patients with corona virus disease 2019(COVID-19)were included in the analysis. Ten patients had high plasma BNP level. The median age for these patients was 60.5 years(interquartile range, 40-80y), and 6/10 (60%) were men. Underlying comorbidities in some patients were coronary heart disease (n=2, 20%), hypertesion (n=3,30%), heart failure (n=1,10%)and diabetes (n=2, 20%). Six (60%) patients had a history of Wuhan exposure. The most common symptoms at illness onset in patients were fever (n=7, 70%), cough (n=3, 30%), headache or fatigue(n=4,40%). These patients had higher aspartate aminotransferase(AST), troponin I, C reactive protein and lower hemoglobin, and platelet count,compared with patients with normal BNP, respectively. Compared with patients with normal BNP, patients with high BNP were more likely to develop severe pneumonia, and receive tracheal cannula, invasive mechanical ventilation, continuous renal replacement therapy, extracorporeal membrane oxygenation, and be admitted to the intensive care unit. One patient with high BNP died during the study. ConclusionHigh BNP is a common condition among patients infected with 2019-nCoV. Patients with high BNP showed poor clinical outcomes
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AimsTo explore the epidemiological and clinical features of 2019 novel coronavirus(2019-nCoV)-infected patients with cardiac injury. Methods and resultsData were collected from patients medical records, and we defined cardiac injury according to cardiac biomarker troponin I level > 0.03 g/L. Among the 291 patients, 15 (5.2%) showed evidence of cardiac injury. Of 15 hospitalized patients with cardiac injury, the median age was 65 years, and 11/15 (73.3%) were men. Underlying cardiovascular diseases in some patients were hypertension (n=7, 46.7%), coronary heart disease (n=3, 20%) and diabetes (n=3, 20%). The most common symptoms at illness onset in patients with cardiac injury were fever (n=11, 73.3%), cough (n=7, 46.7%), headache or fatigue (n=5, 33.3%) and dyspnea (n=4, 26.7%). These patients had higher systolic pressures, white blood cell count, neutrophil count, troponin I, brain natriuretic peptide, D-dimer and lower lymphocyte count, and platelet count, compared with patients without cardiac injury, respectively. Bilateral infiltrates on chest X-ray and elevated C-reactive protein occurred in all patients with cardiac injury. Compared with patients without cardiac injury, patients with cardiac injury were more likely to develop acute respiratory distress syndrome, and receive mechanical ventilation, continuous renal replacement therapy, extracorporeal membrane oxygenation and vasopressor therapy and be admitted to the intensive care unit. ConclusionCardiac injury is a common condition among patients infected with 2019-nCoV. Compared with patients without cardiac injury, the clinical outcomes of patients with cardiac injury are relatively worse.
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Objective:To compare the long-term oncological outcomes between laparoscopic and abdominal surgery in stage Ⅰa1 （lymph-vascular space invasion-positive, LVSI +）- Ⅰb1 cervical cancer patients with different tumor sizes. Methods:Based on the Big Database of Clinical Diagnosis and Treatment of Cervical Cancer in China (1538 project database), patients with stage Ⅰa1 （LVSI +）-Ⅰb1 cervical cancer who treated by laparoscopic or abdominal surgery were included. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) between the two surgical approaches were compared under 1∶1 propensity score matching (PSM) in different tumor diameter stratification. Results:(1) A total of 4 891 patients with stage Ⅰa1 （LVSI +）-Ⅰb1 cervical cancer who underwent laparoscopy or laparotomy from January 1, 2009 to December 31, 2016 were included in the 1538 project database. Among them, 1 926 cases in the laparoscopic group and 2 965 cases in the abdominal group. There were no difference in 5-year OS and 5-year DFS between the two groups before matching. Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS ( HR=1.367, 95% CI: 1.105-1.690, P=0.004). After 1∶1 PSM matching, 1 864 patients were included in each group, and there was no difference in 5-year OS between the two groups （94.1% vs 95.4%, P=0.151）. While, the inferior 5-year DFS was observed in the laparoscopic group (89.0% vs 92.3%, P=0.004). And the laparoscopic surgery was associated with lower 5-year DFS ( HR=1.420, 95% CI: 1.109-1.818, P=0.006). (2) In stratification analysis of different tumor sizes, and there were no difference in 5-year OS and 5-year DFS between the laparoscopic group and abdominal group in tumor size ≤1 cm, >1-2 cm and >2-3 cm stratification (all P>0.05). Cox multivariate analysis showed that laparoscopic surgery were not related to 5-year OS and 5-year DFS ( P>0.05). In the stratification of tumor size >3-4 cm, there was no difference in 5-year OS between the two groups ( P>0.05). The 5-year DFS in the laparoscopic group was worse than that in the abdominal group (75.7% vs 85.8%, P=0.025). Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS ( HR=1.705, 95% CI: 1.088-2.674, P=0.020). Conclusions:For patients with stage Ⅰa1 （LVSI +）-Ⅰb1 cervical cancer, laparoscopic surgery is associated with lower 5-year DFS, and the adverse effect of laparoscopic surgery on oncology prognosis is mainly reflected in patients with tumor size >3-4 cm. For patients with tumor sizes ≤1 cm, >1-2 cm and >2-3 cm, there are no difference in oncological prognosis between the two surgical approaches.
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OBJECTIVE@#To reconstruct a three-dimensional model of female urinary system based on magnetic resonance imaging (MRI) and tomography angiography (CTA) data.@*METHODS@#MRI and CTA datasets were collected from 20 patients in our department in 2018 for reconstructing 3D models of the bladder urethra in resting state using Mimics19.0 software combined with engineering software. The metric parameters of the bladder urethra were analyzed in the reconstructed 3D model.@*RESULTS@#The bladder and urethra were successfully reconstructed using 10 MRI datasets, and the kidney, ureter and bladder were reconstructed using 10 CTA datasets. Using engineering software, we measured a number of cysto-urethral geometric parameters, including the cysto-urethral posterior angle (151.1±17.9°), beta angle (137.3±14.0°), urethral pubic angle (47.8± 12.1°), urethral tilt angle (21.5±7.3°), alpha angle (83.8±13.8°), the posterior pubic space (15.3±3.0 mm), and the urethral striated muscle thickness (2.6±0.6 mm).@*CONCLUSIONS@#Three-dimensional reconstruction of the anatomical model of the human urinary system provides a platform for studying the fine anatomy of the female urinary system and allows measurement of multiple parameters to better understand the functional differences of the bladder and urethra in different populations.
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Female , Humans , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Models, Anatomic , Muscle, Skeletal , Tomography, X-Ray Computed , Urethra , Diagnostic Imaging , Urinary Bladder , Diagnostic ImagingABSTRACT
OBJECTIVE@#To reconstruct a three-dimensional model of female urinary system based on magnetic resonance imaging (MRI) and tomography angiography (CTA) data.@*METHODS@#MRI and CTA datasets were collected from 20 patients in our department in 2018 for reconstructing 3D models of the bladder urethra in resting state using Mimics19.0 software combined with engineering software. The metric parameters of the bladder urethra were analyzed in the reconstructed 3D model.@*RESULTS@#The bladder and urethra were successfully reconstructed using 10 MRI datasets, and the kidney, ureter and bladder were reconstructed using 10 CTA datasets. Using engineering software, we measured a number of cysto-urethral geometric parameters, including the cysto-urethral posterior angle (151.1±17.9°), beta angle (137.3±14.0°), urethral pubic angle (47.8± 12.1°), urethral tilt angle (21.5±7.3°), alpha angle (83.8±13.8°), the posterior pubic space (15.3±3.0 mm), and the urethral striated muscle thickness (2.6±0.6 mm).@*CONCLUSIONS@#Three-dimensional reconstruction of the anatomical model of the human urinary system provides a platform for studying the fine anatomy of the female urinary system and allows measurement of multiple parameters to better understand the functional differences of the bladder and urethra in different populations.
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Female , Humans , Magnetic Resonance Imaging , Models, Anatomic , Tomography, X-Ray Computed , Urethra , Urinary BladderABSTRACT
Objective To analyze the 13 years trend in proportion, risks factors and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China. Methods The clinicopathological data of 46 313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016. Using clinical and pathologic data, each patient′s stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. A total of 19 041 patients were selected according to the following criteria: FIGO stage Ⅰa2 to Ⅱa2, underwent type B or C radical hysterectomy and pelvic lymphadenectomy. All the patients were divided into two groups: the study group of 1 888 patients aged 35 years or younger and the control group of 17 153 patients aged over 35 years. The 13 years trend in proportion of young women with stage Ⅰa2 to Ⅱa2 cervical cancer, risks factors and clinicopathological characteristics of two groups were retrospectively analyzed. Results (1) The total number of hospitalized patients with stageⅠa2 toⅡa2 cervical cancer increased annually. However, a downward trend of patients aged 35 years or younger was observed (P<0.01). The constituent ratio of patients aged 35 years or younger was significantly greater during 2004—2010 than that during 2011—2016 [12.6% (820/6 484) and 8.5% (1 068/12 557), respectively; χ2=82.101, P<0.01]. (2) Compared with patients aged over 35 years, patients aged 35 years or younger had an earlier age at menarche, a later age at marriage, lesser gravida and parity (all P<0.01). The positive rate of high-risk HPV infection was not statistically different between two groups (all P>0.05). (3) The proportions of stageⅠ, exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years (83.4% vs 68.5%, P<0.01; 63.2% vs 56.2%, P<0.01; 13.9% vs 12.0%, P<0.05, respectively). Whereas the poor differentiation ratios of the two groups had no statistical significance (P>0.05). (4) As for the postoperative pathological risk factors, the rate of surgical margin involvement in patients aged 35 years or younger was lower than that aged over 35 years (1.1% vs 1.8%, P<0.05), and the rate of depth of stromal invasion >1/2 in patients aged 35 years or younger was lower than that in patients aged over 35 years (40.1% vs 50.9%, P<0.01). In addition, there were no significant difference in parametrial margin involvement, tumor size and lymph vascular space invasion between two groups (all P>0.05). Conclusions The trend in proportion among hospitalized patients for stageⅠa2 toⅡa2 cervical cancer in young women is decreasing yearly. Compared with cervical cancer in middle-aged and elderly women, cervical cancer in young women have an earlier age at menarche, a higher proportion of stage Ⅰ patients and non-squamous histological type. In terms of the postoperative pathological risk factors, the rate of surgical margin involvement and depth of stromal invasion>1/2 in young women with cervical cancer are lower than in middle-aged and elderly women.
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Objective@#To analyze the 13 years trend in proportion, risks factors and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China.@*Methods@#The clinicopathological data of 46 313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016. Using clinical and pathologic data, each patient's stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. A total of 19 041 patients were selected according to the following criteria: FIGO stage Ⅰa2 to Ⅱa2, underwent type B or C radical hysterectomy and pelvic lymphadenectomy. All the patients were divided into two groups: the study group of 1 888 patients aged 35 years or younger and the control group of 17 153 patients aged over 35 years. The 13 years trend in proportion of young women with stage Ⅰa2 to Ⅱa2 cervical cancer, risks factors and clinicopathological characteristics of two groups were retrospectively analyzed.@*Results@#(1) The total number of hospitalized patients with stage Ⅰa2 to Ⅱa2 cervical cancer increased annually. However, a downward trend of patients aged 35 years or younger was observed (P<0.01) . The constituent ratio of patients aged 35 years or younger was significantly greater during 2004—2010 than that during 2011—2016 [12.6% (820/6 484) and 8.5% (1 068/12 557) , respectively; χ2=82.101, P<0.01]. (2) Compared with patients aged over 35 years, patients aged 35 years or younger had an earlier age at menarche, a later age at marriage, lesser gravida and parity (all P<0.01). The positive rate of high-risk HPV infection was not statistically different between two groups (all P>0.05). (3) The proportions of stage Ⅰ, exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years (83.4% vs 68.5%, P<0.01; 63.2% vs 56.2%, P<0.01; 13.9% vs 12.0%, P<0.05, respectively). Whereas the poor differentiation ratios of the two groups had no statistical significance (P>0.05). (4) As for the postoperative pathological risk factors, the rate of surgical margin involvement in patients aged 35 years or younger was lower than that aged over 35 years (1.1% vs 1.8%, P<0.05), and the rate of depth of stromal invasion >1/2 in patients aged 35 years or younger was lower than that in patients aged over 35 years (40.1% vs 50.9%, P<0.01). In addition, there were no significant difference in parametrial margin involvement, tumor size and lymph vascular space invasion between two groups (all P>0.05).@*Conclusions@#The trend in proportion among hospitalized patients for stage Ⅰa2 to Ⅱa2 cervical cancer in young women is decreasing yearly. Compared with cervical cancer in middle-aged and elderly women, cervical cancer in young women have an earlier age at menarche, a higher proportion of stage Ⅰ patients and non-squamous histological type. In terms of the postoperative pathological risk factors, the rate of surgical margin involvement and depth of stromal invasion >1/2 in young women with cervical cancer are lower than in middle-aged and elderly women.
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Autologous fat grafting has become a commonly used technique in the plastic and reconstructive surgery, due to its availability and biocompatibility and are considered an ideal material for soft-tissue augmentation. We provide a review of the current literature, summarize the current status of autologous fat grafting, including the fat grafting process, complications, and postoperative follow-up, and offer a reference for the clinical application and basic research of autologous fat transplantation.
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AIM:To investigate the effect and mechanism of Aztreonam combined Azithromycin on Pseudomonas aeruginosa ATCC 27853,and clinical separation of 15 strains of Pseudomonas aeruginosain vitro.METHODS:Broth dilution method and checkerboard dilution method were used to determine Aztreonam alone or in combination with Azithromycin on Pseudomonas aeruginosa ATCC27853 and 15 clinical isolates of Pseudomonas aeruginosa.Then,the biofilm formation of the clinical separation of 15 strains of Pseudomonas aeruginosa was identified by Congo red plate method.The crystal violet experiment was used to compare the ability of biofilm formation of Pseudomonas aeruginosa.Growth curve and viable count of Pseudomonas aeruginosa biofilm were investigated by continuous dilution method.The silver staining method was used to observe the biofilm of Pseudomonas aeruginosa by Aztreonam alone and in combination with Azithromycin.RESULTS:Azithromycin combined with Azithromycin on Pseudomonas aeruginosa ATCC 27853 showed synergistic effect;of the 15 isolates of Pseudomonas aeruginosa,6 were synergistic,6 additive,and 3 irrelevant.Congo red plate experiments show that the clinical separation of 15 strains of Pseudomonas aeruginosa,12 strains can formed biofilm,3 did not formed biofilm,and the rate of biofilm formation was 80％.The results of crystal violet experiment showed that the biofilm formation ability of 16091217 was the strongest when compared with other strains.The continuous dilution method of viable bacteria count experiment showed that the number of viable bacteria in Azithromycin group,Aztreonam group was significantly different compared with Azithromycin + Aztreonam group.The silver staining method showed that the inhibition effect of Azithromycin on the formation,early and mature stages of biofilm formation.CONCLUSION:The study found that the effect of Aztreonam combined with Azithromycin was mainly synergistic and additive in vitro.Aztreonam combined with Azithromycin presents synergistic bactericidal effect on Pseudomonas aeruginosa biofilm formation.
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OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:In retrospective study, the distribution,composition and drug resistance of pathogens in our hospital during Jan.-Dec. in 2015 were analyzed statistically. RESULTS:In 2015,a total of 9401 specimens were collected in microbiology laboratory of our hospital;pathogens were detect-ed in 1743 specimens with positive rate of 18.54%;1591 strains of pathogens were isolated,mainly from sputum (59.77%), urine (14.775) and blood sample (8.93%). Totally 347 strains of Gram-positive bacteria(21.81%),991 strains of Gram-negative bacteria (62.29%),253 strains of fungus (15.90%)were detected. Top 4 pathogens in the list of amount were Escherichia coli, Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus. S. aureus,Streptococcus pneumoniae and Staphylo-coccus haemolyticus were sensitive to vancomycin,linezolid and sodium fusidate,with resistance rate of 0;resistance rates of them to erythromycin were more than 65%. The resistance rate of S. aureus to penicillin was more than 95%,and S. haemolyticus showed high resistance rate to common antibiotics. Drug resistances of E. coli,K. pneumoniae and P. aeruginosa to carbapenems were all lower than 15%,and they were sensitive to polymyxin with resistance rate of 0. Resistance rate of E. coli to quinolones was more than 50%. CONCLUSIONS:The main pathogens are Gram-negative bacteria in our hospital,drug resistance of them are not satisfactory. Drugs most sensitive to main pathogens include vancomycin,linezolid,carbapenems,etc. The inspection of patho-gen drug resistance characteristics should be strengthened,and antibiotics should be selected rationally and normatively according to the results of drug sensitivity test.
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Purpose Full-term fetal weight is closely related to the choice of delivery mode and perinatal mortality rate.Our aim is to explore the feasibility of magnetic resource image (MRI) with three-dimensional reconstruction and volume measurement in estimating fetal weight and its accuracy compared to ultrasound (US) examination.Materials and Methods Analyzed the MRI volume measurement of 61 fetuses delivered within 7 days after M RI and ultrasound examination in our hospital between November 2013 and March 2016 using MRI three-dimensional reconstruction.The fetal weight estimated by MRI was calculated by the equation developed by Baker et al and the US estimation of fetal weight was performed according to Haldlock et al,the MRI and US estimation of fetal weight were compared.Results 60 fetuses were included and qualified MRI three-dimensional reconstruction models,one was excluded because of frequent movement.The MRI estimation of fetal weight and the birth weight correlated significantly (r=0.927,P＜0.05).The MRI estimation of fetal weight had a lower percentage of random error than US (3.4％ vs 5.0％,P＞0.05),as well as mean absolute error [(172+ 114) g vs (227± 171) g,P＜0.05],but a higher percentage of relative error ≤ 10％ than US (95.0％ vs 78.3％,P＜0.05),with an underestimation in 90.0％ fetuses compared with birth-weight.Concision Full-term fetal weight estimation by using MRI with three-dimensional reconstruction and volume measurement is feasible and more accurate than ultrasound,but lower than the actual weight.This method can be applied in estimating fetal weight in the case of ultrasound examination limited.
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Background Carbachol solution (0.01％) is an agonist of M cholinoceptor and skeletal muscle N cholinoceptor,and it is used to play miotic effect and open peripheral iridectomic hole during the surgery of implantable collamer lens (ICL) implantation in order to lower intraocular pressure (IOP).However,the anterior chamber injection of 0.01％ carbachol solution often causes relevant complications,while whether lower dose of carbachol solution is effective and safe is unclear.Objective This study was to compare the effectiveness and safety between 0.01％ carbachol solution and 0.005％ carbachol solution after anterior chamber injection during the ICL implantation.Methods One hundred and fifty-two eyes of 76 cataract patients were included in Daping Hospital of Third Military Medical University from September 2014 to September 2015.ICL implantation and periphery iridectomy were carried out on both eyes of the patients and the 0.01％ carbachol solution was injected into the anterior chamber during the surgery of the right eyes and 0.01％ carbachol solution was used in the left eyes.The operation duration and IOP at postoperative 2 hours and systemic choline-like reaction were compared between 0.01％ carbachol solution group and 0.005％ carbachol solution group.Results The mean operation duration was (11.86± 2.39) minutes and (11.22 ± 1.85) minutes in the 0.01％ carbachol group and 0.005％ carbachol group,without significant difference between two groups (t =1.851,P =0.066).IOP was (15.76 ± 2.18) mmHg and (13.58 ±2.24)mmHg in the 0.01％ carbachol group before and after surgery,and those in the 0.005％ carbachol group was (15.70±2.35)mmHg and (13.12±2.17)mmHg,there was no significant difference in the IOP between the two concentrations of carbachol (Fsroup =0.986,P=O.322).The IOP at postoperative 2 hours was lower than that before operation,the difference was statistically significant(Ftime =97.339,P =0.000).There was no interaction between drug concentration and time (Fcorrelation =0.772,P =0.381).The incidences of complications,such as dizziness,nausea and vomiting,were lower in the 0.005％ carbachol group than those in the 0.01％ carbachol group (x2 =13.01,5.16,4.03,all at P＜0.05).Conclusions Carbachol solution (0.005％) can play intraoperative miosis effect and maintain effective operation duration in ICL implantation.In addition,the application of 0.005％ carbachol solution is quite safe in both intraoperation and postoperation.
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Objective To construct the digitalized 3 dimensional(3D)model by using the CTA and MRA original images and to assess the differences in the pelvic and abdominal vessel display between CTA and MRA.Methods The original data set in 25 healthy youth female cases of CTA and MRA were collected.The datasets,reconstructed the 3D models of arteries and venous on 3D reconstruction software Mimics10.0 was used to construct the 3D model of pevic and abdominal vessels.The reconstruction situation of abdominal aorta,inferior vena cava,common iliac artery and common iliac venous,internal and external iliac artery and iliac venous,uterine artery,obturator artery and obturator venous,hip artery and its branches,internal pudendal artery,middle sacral artery and venous,ovarian artery and venous and sacral venous plexus were observed.Moreover the chi-square test was used to analyze whether the above vessel display rate having differences between the two kinds of model.Results The abdominal aorta,inferior vena cava,common iliac artery and common iliac venous,internal and external iliac artery and iliac venous and uterine artery almost reached 100 ％ display.The display rates of CTA model for right and left obturator artery and venous were 92 ％,80 ％,44 ％ and 32 ％ respectively,while which of MRA model were 84 ％,72 ％,36 ％ and 4％ respectively,the difference was not statistically significant(P =0.382,P=0.508,P =0.564,P =0.382).The sacral venous plexus,including S1,2,3,4 transverse vein,the display rates in 25 cases of CTA 3D models were 4％,8％,0％and 4％respective,while which of MRA models were 76％,92％,96％and 44％respectively,the differences between them were statistically significant(P＜0.01,P＜0.01,P＜0.01,P=0.01).Conclusion Based on the observation of 3D models,the displaying rate of grade 4 pelvic and abdominal vessels has no statistical difference between MRA imaging technology and currently widely used CTA technology,moreover the MRA technology is superior to the CTA technology in presacral vessel net display.
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Objective To investigate the related factors on effects of uterine artery embolization (UAE) in the treatment of dysmenorrhea in patients with adenomyosis, and to construct and validate the efficacy prediction model. Methods A total of 127 cases of adenomyosis patients with symptoms of dysmenorrhea in Guangzhou No.1 People′s Hospital and Nanfang Hospital of Southern Medical University from June 1999 to December 2009 were reviewed. The evaluation standard was to improve the degree of dysmenorrhea, the related factors of efficacy were analysed. Combined with artificial neural network theory, the effect prediction model was constructed, and the effectiveness of the model was evaluated using receiver operating characteristic (ROC) curve, and the effectiveness of the cut-off point was calculated. The model was validated by 68 cases of patients with adenomyosis in the Nanfang Hospital from January 2010 to November 2014. Results (1) In 127 cases of dysmenorrhea patients, UAE treatment was effective in 98 cases, effective rate was 77.2% (98/127). (2) Age was an independent predictor of effective UAE treatment (HR=1.129, P=0.026);in the range of this study, the greater the age, the higher the UAE treatment efficiency. (3) The developing situation of ovary branches of uterine artery was an independent predictor of effective UAE treatment (HR=0.460, P=0.020), the efficiency of patients whose intraoperative bilateral uterine artery ovarian branch did not develop was 89.7%(35/39), the efficiency of patients whose unilateral uterine artery ovarian branch was developing was 84.1% (37/44) and the efficiency of patients whose bilateral uterine artery ovarian branch were developing was 59.1% (26/44). (4) Blood supply of adenomyosisis was an independent predictor of effective UAE treatment (HR=0.313, P=0.001). Type Ⅰ (bilateral predominated) patients, efficiency was 93.5%(43/46);typeⅡ(bilateral balanced) patients, efficiency was 78.0%(39/50);type Ⅲ (unilateral predominated) patients, efficiency was 51.6% (16/31). (5) UAE for the treatment of adenomyosis efficacy of artificial neural network prediction model was constructed, the model′s area under the ROC curve was 0.808, the optimal cut-off point was 0.669 13. Actual verification of the model, sensitivity was 96.5%, specificity was 81.8%, positive predictive value was 96.5%and negative predictive value was 81.8%, the total accuracy was 94.1%. Conclusions (1) Age, the developing situation of ovary branches and blood supply of adenomyosis are the independent predictors of effective UAE treatment. (2) The artificial neural network prediction model is satisfied with the accuracy and the accuracy of prediction.
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Objective To investigate the invasion situation of cardinal ligaments(CL) in stage Ⅰ A2 - ⅡA2 cervical cancer and to find the high risk clinicopathological factors affecting its invasion .Methods The retrospective analysis was performed on the clinicopathological data in 2 982 patients with cervical cancer treated by operation extracted in 5 hospitals from January 2004 to De‐cember 2014 .Results (1) Totally 855 cases according with the research condition were included .The CL invasion was found in 20 cases(2 .3% ) .No CL invasion occurred in the stage ⅠA2 ,the CL invasion rate in the stage ⅠB1 was 1 .7% ,in the stage ⅠB2 was 1 .2% ,in the stage ⅡA1 was 5 .7% and in the stage ⅡA2 was 2 .9% .With the increase of FIGO staging ,the CL invasion rate had no significant increase(P=0 .269) .(2) The infiltration rate of left CL and right CL had no statistical difference among the stageⅠA2- ⅡA2(P=1 .000) .And the invasion rate of the left CL with different FIGO stages had no statistical difference(P=0 .286) , while the right one had statistical difference(P=0 .005) ,in which the highest was in the stage ⅡA1 (4 .3% ) .(3)The univariate a‐nalysis found that lymph‐vascular invasion ,cervical stroma infiltration depth ,pelvic lymph node metastasis ,uterus body infiltration and vaginal fornix infiltration were the risk factors of CL invasion(P<0 .01);the further multivariate analysis determined that the invasion of uterine body(OR=11 .858) ,pelvic lymph node metastasis(OR=6 .359 ,) ,vaginal fornix infiltration(OR=6 .012 ,) were the risk factors for CL invasion(P<0 .05) .Conclusion The invasion rate of CL invasion in early stage cervcial cancer is low .The invasion of uterine body ,pelvic lymph node metastasis and vaginal fornix filtration are the risk factors for CL invasion in the stageⅠA2- ⅡA2 cervical cancer .