Evaluation of pretreatment methods for filamentous fungal detection.

In order to obtain the best mass spectrometry identification results for using the most appropriate methods in clinical practice, we explore the optimal pretreatment methods for different species and morphologies of filamentous fungi. 98 fungal strains were treated with formic acid sandwich method, dispersion method, extraction method, and other methods using a medium element mass spectrometer (EXS3000) as a platform. Each strain had three targets, and the identification rates and confidence differences under different pre-treatment methods were compared to evaluate the identification effects of these methods. The mass spectrometry identification rates of 98 filamentous fungi obtained after pre-treatment with formic acid sandwich method, dispersion method, and extraction method were 85.71%, 82.65%, and 75.51%, respectively. The identification rate of the formic acid sandwich method was significantly higher than the other two methods (P < 0 005) has the best identification ability and the obtained confidence is also higher than the other two methods. The use of formic acid sandwich method for mass spectrometry identification of filamentous fungi can achieve ideal identification results, which is suitable for mass spectrometry identification of filamentous fungi in conventional laboratories.

[Influencing factors for the performance of trainees after hands-on training of endoscopic retrograde cholangiopancreatography].

OBJECTIVE: To evaluate the performance of trainees after finishing hands-on training of endoscopic retrograde cholangiopancreatography (ERCP) at our hospital. METHODS: Questionnaire was distributed to 46 trainees of ERCP training over the past 5 years. And the effects of training duration, case volume and hospital facilities on ERCP performance were examined. RESULTS: A total of 41 valid questionnaires (89.1%) were retrieved. And 34 trainees (82.9%) worked at tertiary medical centers. The mean training duration was 8.9 months. Compared with trainees with less annual ERCP volume (TL) (< 4 cases per month, n = 23), trainees with more volume (TM) (≥ 4 cases per month, n = 18) had a higher rate of successful cannulation and precut by a needle knife (both P < 0.05). More endoscopists could perform ERCP and more duodenoscopes were stocked at hospitals of TM compared with TL (both P < 0.05). The results of trainee self-evaluation showed that the major influencing factors of post-training ERCP performance were hospital supports, handling capacity and case volume. CONCLUSION: After hands-on training, the trainee performance of ERCP is influenced by such multiple factors as handling capacity and hospital supports, etc.

Postoperative endoscopic surveillance of human living-donor small bowel transplantations.

AIM: To determine the significance of endoscopic surveillance in the diagnosis of acute rejection after human living-donor small bowel transplantations. METHODS: Endoscopic surveillance was performed through the ileostomy after human living-donor small bowel transplantations. The intestinal mucosa was observed and biopsies were performed for pathological observations. RESULTS: Acute rejection was diagnosed in time by endoscopic surveillance. The endoscopic and pathological manifestations of acute rejection were described. CONCLUSION: Endoscopic surveillance and biopsy are reliable methods to diagnose the acute rejection after human living-donor small bowel transplantations.