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BACKGROUND: In the first half 2022, SARS-CoV-2 variant omicron rapidly spread in Shanghai. CASE PRESENTATION: A 74-year-old woman, diagnosed as having rheumatoid arthritis for almost 30 years and treated with prednisone and cyclophosphamide, went through nasopharyngeal swab RNA test for SARS-CoV-2 for routine screening and was positive. She was then sent to the designated hospital. After negative RNA test, the patient returned to the former hospital for the treatment of basic disease. Unfortunately, the RNA test of this patient became positive again. And in this period, the clinical manifestations and computed tomography scans were more progressive. Finally, the patient passed away. CONCLUSION: There is a long way to go for us to study expression characteristics of SARS-CoV-2.
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Arthritis, Rheumatoid , COVID-19 , Female , Humans , Aged , SARS-CoV-2 , RNA, Viral , ChinaABSTRACT
Pneumocystis jirovecii pneumonia (PJP) in advanced prostatic cancer patients not receiving high-dose glucocorticoids has been reported rarely. A 73-year-old man underwent chemotherapy with cisplatin and docetaxel for advanced prostatic cancer. After nine cycles of chemotherapy, he developed a high fever, dry cough, shortness of breath, and severe fatigue, with rapid-onset hypoxic respiratory failure. Investigations demonstrated bilateral ground-glass opacities with positive bronchoalveolar lavage fluid (BALF) for Pneumocystis jirovecii by next-generation sequencings (NGS). The patient recovered well with treatment with trimethoprim-sulfamethoxazole, caspofungin, and corticosteroids. This case report describes a case of PJP in a patient with a solid tumor who did not receive high-dose glucocorticoids and emphasizes the importance of early diagnosis and treatment.
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Pneumocystis carinii , Pneumonia, Pneumocystis , Prostatic Neoplasms , Aged , Glucocorticoids/therapeutic use , Humans , Male , Pneumonia, Pneumocystis/diagnosis , Pneumonia, Pneumocystis/drug therapy , Prostatic Neoplasms/complications , Prostatic Neoplasms/drug therapy , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useABSTRACT
BackgroundChest CT had high sensitivity in diagnosing novel coronavirus pneumonia (NCP) at early stage, giving it an advantage over nucleic acid detection in time of crisis. Deep learning was reported to discover intricate structures from clinical images and achieve expert-level performance in medical image analysis. To develop and validate an integrated deep learning framework on chest CT images for auto-detection of NCP, particularly focusing on differentiating NCP from influenza pneumonia (IP). Methods35 confirmed NCP cases were consecutively enrolled as training set from 1138 suspected patients in three NCP designated hospitals together with 361 confirmed viral pneumonia patients from center one including 156 IP patients, from May, 2015 to February, 2020. The external validation set enrolled 57 NCP patients and 50 IP patients from eight centers. Results96.6% of NCP lesions were larger than 1 cm and 76.8% were with intensity below -500 Hu, indicating less consolidation than IP lesions which had nodules ranging 5-10 mm. The classification schemes accurately distinguished NCP and IP lesions with area under the receiver operating characteristic curve (AUC) above 0.93. The Trinary scheme was more device-independent and consistent with specialists than the Plain scheme, which achieved a F1 score of 0.847, higher than the Plain scheme (0.774), specialists (0.785) and residents (0.644). ConclusionsOur study potentially provides an accurate early diagnosis tool on chest CT for NCP with high transferability, and shows high efficiency in differentiating NCP and IP, helping to reduce misdiagnosis and contain the pandemic transmission.
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Objective To explore the overall research focus and frontier of master of nursing specialist at home and abroad to provide reference for the development of master of nursing specialist in China.Methods The numbers of literatures from 2006 to 2016 that related to master of nursing specialist are 1 595 in web of science and 249 in China National Knowledge Internet respectively.Knowledge mapping and visual analysis were carried out by CiteSpace.Results In 2006-2016,the numbers of both domestic and foreign relevant literatures were generally on the rise.The international researchers focused on the research of nurse practitioners and primary care,while Chinese ones on curriculum,training pattern,core competencies,etc.The current international frontier was in the field of systems and team,while the Chinese one was in the field of education and training model.Conclusion There is a certain gap between the research of master of nursing specialist at home and abroad.Our country should take our own national conditions as the basis and learn from foreign research focus and frontiers to promote the development of master of nursing specialist.
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Objective To evaluate the experience of laparoscopic complete mesocolic excision (CME) for right colon cancer.Methods 45 patients with right colon cancer underwent laparoscopic CME were selected as research subjects(laparoscopy group),and 40 patients with right colon cancer underwent open CME were selected as control group(open group).The clinical effects of the two groups were observed .Results All the 45 cases were successfully performed with laparoscopic CME and 40 specimens were evaluated pathologically as mesocolic plane surgery. The average time for passage of flatus in the laparoscopy group [(3.43 ±0.72)d] was less than that in the open group [(4.10 ±0.99)d,P =0.039,P <0.05].The average time of leaving bed [(3.39 ±0.66)d] in the laparoscopy group was significantly less than that in the open group [(4.20 ±0.79)d,P =0.005,P <0.05].The mean operative time of the laparoscopy group [(160.93 ±20.91)min] was longer than that of the open group [(103.00 ±24.29)min,P =0.000,P <0.05].The average number of total lymph nodes removed of the laparoscopy group [(23.16 ±8.21)] was higher than that of the open group [(19.06 ±7.48)],but the difference was not statistically significant between the two groups (P =0.102,P >0.05).The overall postoperative complication rate of the laparoscopy group was 13.33%,which was lower than 22.50% of the open group,but the difference was not statistically significant between the two groups(P =0.268,P >0.05).Conclusion Laparoscope complete mesocolic excision for right colon cancer is safe and feasible.
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Patient satisfaction is an important index of hospital quality evaluation and performance evaluation.This study established multi-attribute patient satisfaction index system based on the theory of customer satisfaction index,determined the index weight by combination weighting approach,and graded the hospitals and adjusted the weights by the RSR method.A set of comprehensive evaluation scheme is initially formed,which is suitable for patient satisfaction evaluation and performance evaluation.
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Objective To evaluate the performance of Sysmex XN‐9000 automated hematology analyzer .Methods According to international and domestic standards ,performance of analyzer was evaluated .Results The within‐batch and between‐batch preci‐sion ,carryover pollution rate ,linearity range and the accuracy of Sysmex XN‐9000 analyzer were all conform to related require‐ments .Leukocyte classification results compared with manual classification ,the correlation of neutrophil ,lymphocyte ,monocyte and eosinophil were fine ,but correlation of basophil was not very ideal .Conclusion The performance of Sysmex XN‐9000 analyzer could be satisfying ,could meet the needs of clinical inspection and diagnosis and treatment .
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Objective Examination and evaluation of employee satisfaction index in the hospital performance evaluation.Methods Stratified sampling,field survey and telephone survey were used in customizing a questionnaire for two surveys in July and December 201 5 respectively.Results The standardized score of employee satisfaction was 86.252±1 5.1 53,and the lowest score was found in the canteen environment and food quality.Conclusion Employee satisfaction is found as good overall,and targeted measures are recommended to improve insufficiencies for better employee satisfaction.
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<p><b>OBJECTIVE</b>To study the effects of Meilian Xiaoke capsule (a traditional Chinese medicinal preparation) combined with metformin for protecting islet cells and lowering blood glucose in diabetic rats.</p><p><b>METHODS</b>Rat models with type 2 diabetes, established by high-fat and high-glucose diet combined with streptozotocin (STZ) injection, were treated with a low dose of metformin, Meilian Xiaoke capsule, or both for 4 weeks by gavage. Blood glucose level was tested in the rats, and islet pathologies and changes in islet β cell number after the treatment were observed with HE staining and aldehyde fuchsin staining, respectively.</p><p><b>RESULTS</b>Treatment with metformin or Meilian Xiaoke capsule alone for 2 or 4 weeks did not produce significant improvement of blood glucose in the diabetic rats. Their combined treatment for 4 weeks resulted in significantly lowered blood glucose level and improved glucose tolerance with also obviously increased islet β cell number and lessened islet pathologies.</p><p><b>CONCLUSIONS</b>Meilian Xiaoke capsule and metformin show a synergistic effect to significantly enhance the therapeutic effect in rats with type 2 diabetes.</p>
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Animals , Rats , Blood Glucose , Diabetes Mellitus, Experimental , Drug Therapy , Diabetes Mellitus, Type 2 , Drug Therapy , Drug Synergism , Drugs, Chinese Herbal , Pharmacology , Hypoglycemic Agents , Pharmacology , Insulin-Secreting Cells , Pathology , Metformin , Pharmacology , StreptozocinABSTRACT
Objective To detect the excision repair cross-complementing gene 1 (ERCC1) and thymidylate of the acid synthase (TS) in non-small cell lung cancer (NSCLC) and its adjacent tissue,and investigate the relationship of the expression of ERCC1 and TS with the clinical characteristics of NSCLC and prognosis for NSCLC individual therapy to provide experimental basis.Methods The protein expression levels of ERCC1 and TS in 50 cases of postoperative NSCLC cancer and adjacent tissue were detected by immunohistochemical method and the relationship among the expression of ERCC1,TS,and overall survival of patients with NSCLC Phase (OS),disease progression time (TTP),the median OS,and median TTP was analyzed.Results (1)There was an obvious difference between the expression of ERCC1,TS in cancer and paraneoplastic tissue of NSCLC,which had statistically significance (64.00％ vs 20.00％,x2 =19.87,P ＜ 0.01 ;48.00％ vs 24.00％,x2 =6.25,P ＜ 0.05) ; (2)The continued investigation in the patients who received postoperative cisplatin or carboplatin chemotherapy showed that the 0S of negative expression of ERCC1 was significantly longer than the positive one (19.10 vs 10.00 months;x2 =8.133,P =0.002),so was median TTP (15.30 vs 9.00 months; x2 =7.410,P =0.003).The median 0S of the negative expression of TS,was significantly longer than the positive one (17.80 vs 11.00 months,x2 =7.001,P =0.008),so was median TTP (11.40 vs 6.80 months; x2 =5.884,P =0.026).Conclusions ERCC1 and TS protein may become sensitive predictors of platinum chemosensitivity for NSCLC patients ; the detection of combined with ERCC1 and TS would contribute to the selection of individualized treatment programs for NSCLC.
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Objective To develop an instrument to measure the quality of life (QOL) suitable for Chinese adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and evaluate it. Methods A list of 72 items potentially related to QOL of patients with OSAHS was constructed via discussion with OSAHS related people, as well as referring to some foreign QOL instruments. Twenty patients were asked to identify the most significant items. Then, frequency, importance and impact score, which is the product of frequency and importance, of the items were calculated. Those items with an impact score equal to or greater than 1.5 were retained in the instrument. Fifty-two OSAHS patients were divided into two groups based on their apnea-hypopnea index (AHI) (AHI
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With the development of science and technology,especially the development of medical technology,human beings have an increasing power in controlling their life and their reproduction.As a means of self intervention,reproductive technology on the one hand can solve some infertility problems and achieve the objective of aristogenesis,but on the other hand has also brought relevant problems related to rights,obligations, ethics,family and social issues.How do we weigh these complicated problems in the intersection of ethics and science.'? This paper aims to find a balancing point through relevant discussions and consultations to achieve the common development of science and ethics.
