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Objective@#To understand delay in treatment student tuberculosis (TB) patients in Wuhan from 2011 to 2018, and to provide a reference for prevention and control measures of tuberculosis in schools.@*Methods@#The medical cases of students with tuberculosis in Wuhan recorded by the national tuberculosis management information system during 2011-2018 were analyzed for the delay and change trend of medical treatment of students with tuberculosis, and Logistic regression was used to analyze influencing factors.@*Results@#The median number of student TB patients seeking treatment in Wuhan was 9(3,21) days, and 51.14% of student TB patients were delayed. From 2011 to 2018, the overall delay rate of TB patients in students decreased slowly and then gradually increased, decrea sing from the highest rate (56.4%) in 2011 to the lowest one (45.6%) in 2014, and then gradually increased to 53.8% in 2018, there was no significant difference in the delay rate between the first and the second four years(χ2=2.84, P=0.09); The delay rate of different gender students was the same as that of the whole. The fluctuation of female students was slightly obvious, but the difference was not statistically significant(χ2=0.07, P>0.05); Among the students of different age groups, the delay rate of 13-18 years old was the lowest(χ2=87.23, P<0.01). The delay rate of 19-22 years old and university groups of different school levels showed a slow decline, while that of other age groups and other school level groups showed an overall upward trend. The results of multivariate logistic regression analysis showed that the main factors affecting the delay rate of medical treatment were the remote urban area(OR=1.84, 95%CI=1.56-2.16), the ethnic minorities (OR=2.73, 95%CI=1.46-5.09) and the age of 13-18(OR=0.57, 95%CI=0.33-1.00).@*Conclusion@#Delay in treatment of TB patients in Wuhan is not optimistic, with more than half of the students have delayed in treatment, the main factors that affect the high rate of TB patients’ treatment delay are the students in the far urban areas and ethnic minorities. It is very important to take targeted prevention and control measures to guide the students to actively seek medical treatment according to the time, the place and the person.
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Objective@#To evaluate the efficacy and safety of drug-coated balloons (DCB) for de novo large coronary vessels.@*Methods@#One hundred and two patients were retrospectively enrolled in this study, there were 104 lesions with the reference lumen diameter of target vessel more than 2.8 mm and patients were treated with DCB in de novo lesions during May 2015 and July 2017 in our center. Coronary artery angiography and quantitative coronary angiography were performed in 82 (80.4%) patients at follow up period ((8.1±1.7) months post procedure). The endpoints were late lumen loss (LLL) at follow up,and major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent or target lesion thrombosis at 12 months post procedure.@*Results@#Ninety-eight lesions were treated with DCB only, 6 (5.9%) bailout drug-eluting stent (DES) were used because of severe coronary dissection, 2 patients (2.0%) received revascularization driven by acute ischemic events during hospitalization. Cutting balloons and NSE balloons were used in 65.4% (68/104) and 26.0% (27/104) lesions. The lesion length was (12.57±3.58) mm and the DCB length was (19.87±4.55) mm. The late lumen loss was (0.01±0.52) mm during angiographic follow up. The TLR rate and overall MACE rate was 3.9% (4/102) and 3.9% (4/102) and there was no death,MI and target lesion thrombosis at 12 months follow up.@*Conclusion@#DCB treatment for de novo large coronary vessels is effective and safe.
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Objective To investigate the value of continuous renal replacement therapy (CRRT) coupled with minimally invasive ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) for the treatment of severe acute biliary pancreatitis.Methods Hospitalized patients with severe acute biliary pancreatitis were recruited from the intensive care unit (ICU) of the Mfiliated Hospital of Qingdao University from June 2010 to June 2015,and divided into conventional CRRT alone group (n =30) and CRRT + PTGD group (n =30).Comparisons of postoperatively symptoms (time required for abdominal pain relief,time consumed for,gastrointestinal decompression),laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT,ALB,Lac) and acute physiology and chronic health evaluation score (APACHE Ⅱ,Balthazar CT,MODS) were carried out between two groups.The occurrence of complications (ARDS,abdominal infection,bile leakage,abdominal hemorrhage,intestinal injury,catheter translocation,catheter dislocation) was observed.The differences in duration of ventilator support,the length of stay in ICU,and fatality rate were compared between the two groups.Results Compared with the conventional CRRT alone group,the postoperative symptoms were significantly relieved,and time required for abdominal pain relief and time consumed for gastrointestinal decompression were evidently shortened in the CRRT + PTGD group (P ＜ 0.05).There were statistically significant differences in laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT) between two groups (P ＜ 0.05).The differences in APACHE Ⅱ,Balthazar CT and MODS score between the two groups also presented statistical significance (P ＜ 0.05).The comparisons of the duration of ventilator support [(6.1 ± 1.3) d vs.(9.5 ± 1.4) d] andthe length of stay [(15.7 ± 1.1) dvs.(21.1 ± 2.5) d] between thetwo groups revealed statistical significance (P ＜ 0.05).Conclusions CRRT coupled with PTGD for the treatment of severe acute biliary pancreatitis can effectively eliminate the inflammatory mediators and toxins from patients.On this basis,the coupled therapy with gallbladder puncture and drainage is capable of decompressing the biliary tract,improving liver function,effectively relieving clinical symptoms,minimizing the changes of laboratory findings an,d APACHE Ⅱ score,and thereby optimizing the prognosis of patients.
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Objective To explore clinical value of the color Doppler ultrasonic(CDU)and TNM staging of renal cell carcinoma.Methods 265 cases of renal cell carcinoma(RCC)confirmed by surgical pathology were retro-spectively analyzed.According to the WHO 2004 pathological types of classification standards and the American Joint Committee on Cancer(AJCC)cancer staging manual/6th TNMstaging criteria.The analyzed application of a CDFI to TNMstaging of renal cell carcinoma,and surgical pathology results werecompared.Results 265 cases of RCC and right kidney in 136 cases,129 cases of left kidney;Diameter of 1.5 -12.8cm;Pathological diagnosis of renal clear cell carcinoma in 226 cases(85.28%),28 cases of papillary renal cell carcinoma(10.57%),renal too color cell car-cinoma in 5 cases(1.89%),4 cases of multilocular cystic renal cell carcinoma(1.51%),Bellini duct carcinoma in 2 cases(0.75%).Diagnosis results of CDU and pathological in 250 cases(94.34%),CDU misdiagnosis leakage 15 cases(5.66%).Within the kidney showed low echo or high echo,and mixed echo lumps,and invasive growth to the surrounding tissues or organs sign for it.CDU showed the various blood flow signals were given priority to with renal clear cell carcinoma;CDU and surgical pathology TNMstaging coincidence rate was 90.40%(226 /250),inclu-ding T1 N0 -1 M0 ,T2 N0 -1 M0 ,T3 N0 -2 M0 -1 and T4 N0 -2 M0 -1 of coincidence rate were 92.12%(152 /165),85.71%(36 /42),82.14%(23 /28)and 100.00%(15 /15).Conclusion CDU can be used as the preferred method of diag-nosis and evaluation of renal cell carcinoma,which can can provide valuable information for TNMstaging.
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Objective To explore the value of virtual touch tissue quantification (VTQ ) in the diagnosis of pancreas early damage of patients with hyperuricemia(HUA) .Methods Sixty‐five cases of patients with normal glucose tolerance and HUA (HUA group) and 42 cases of patients with HUA and impaired glucose tolerance (IGT group) were included in the study ,and other 150 health subjects were taken as control group .After routine ultrasound examination ,the pancreas shear wave velocity values (Vs) of different groups were measured by VTQ technology ,and the results were analyzed .Results Compared with the control group ,the rate of the abnormai ultrasonogram of pancreas in IGT group showed obvious increasing trend but there was no significantly difference between the other groups(both P >0 0.5) .The Vs of the normal control group ,HUA group ,and IGT group were (1 2.1 ± 0 1.5)m/s ,(1 4.1 ± 0 1.3)m/s and (1 5.9 ± 0 1.5)m/s ,respectively .The Vs of HUA group and IGT group were higher than that of the control group (both P <0 0.5) ,and the Vs of IGT group was significantly higher than that of HUA group ( P <0 0.5) .Conclusions Hyperuricemia may cause pancreas damage ,and with the disease progress ,the pancreas damage became more serious ,and VTQ technology may play an important role on the diagnosis of pancreas early damage in HUA patients .
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Objective To investigate the value of bone morphogenetic protein-7 (BMP-7) and the kidney shear wave velocity (SWV) in the diagnosis and treatment of diabetic nephropathy.Methods 150 cases of patients with diabetic mellitus were divided into three groups according to 24h urinary albumin excretion (Ualb):normalbuminuria (NA) group,microalbuminuria (MA) group and clinical proteinuria (CA) group;50 healthy subjects were selected as the control group (NC).The levels of blood BMP-7 were detected and the virtual touch tissue quantification (VTQ) was used to detect renal SWV in four groups.Both the BMP-7 level and the renal parenchyma SWV were compared among four groups.Then correlation analysis was made between blood of BMP-7 level and renal SWV in diabetic nephropathy groups.Results Blood BMP-7 level:the lowest was CA group,the middle one was MA group,and the highest was NA group (P ＜0.05),the NC group and the NA group had no significant difference (P ＞0.05); SWV measured values:CA group was the highest,MA group was middle one and the NA group was the lowest (P ＜ 0.05),the difference between NC group and the NA group was not significant statistically (P ＞0.05).The blood levels of BMP-7 and renal SWV had a significant negative correlation (r =-0.612,P ＜0.05).Conclusions The blood BMP-7 levels downregulate with the progressing of diabetic nephropathy,but the renal SWV increases with the diabetic nephropathy deterioration,and may indirectly reflects blood BMP-7 levels.Both of them have important application values in the diagnosis or treatment of diabetic nephropathy.
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Objective To investigate the clinical value of echo-tracking(ET) technique in evaluating the carotid elasticity in patients with hyperuricemia and hyperuricemia combined with hyperlipidemia.Methods One hundred and twenty patients with hyperuricemia were divided into two group:group of hyperuricemia (group A) and group of hyperuricemia combined with hyperlipidemia (group B).Sixty normal persons were served as the control group.ET was used to measure the carotid artery elastic modulus including stiffness parameters (β),pressure-strain elastic modulus (Ep),arterial compliance (AC),augmentation index (AI) and pulse wave conducting velocity (PWVβ).Then the statistical data were analyzed to observe the changes of each parameter.Results In the comparison of three groups,elastic function index β,Ep,PWVβ and AI in group A and group B were higher than those of control group (P ＜0.05) ;however,AC was lower than that of control group (P ＜ 0.05).Compared with group A,elastic function index β,Ep,PWVβ,AI was higher in group B,while the AC was lower than that of group B (P ＜0.05).Conclusions ET may be helpful to prevent atherosclerotic changes and to provide the basis for the clinical diagonosis and treatment atherosclerotic changes.
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Objective To explore the effects of walking exercise on glycometabolism,dynamic blood pressure and the quality of life of patients with both hypertension and type 2 diabetes on the basis of conventional drug treatment.Methods Sixty-two patients with both hypertension and diabetes who could support taking walking exercise of more than 5,000 steps/d were randomly divided into a walking exercise group (32 cases) and a control group (30 cases).Both groups were given conventional drug treatment (including valsartan,acarbose and metformin).Those in the walking exercise group took more than 10,000 steps/d of aerobic exercise while the patients in the control group were just given normal community care.This continued for a period of 3 months.Fasting plasma glucose (FPG),glycated hemoglobin-A1C (HbA1c),fasting insulin (FINS),the homeostasis model of assessment for insulin resistence index (HOMA-IR),the homeostasis model of assessment for insulin sensitivity (HOMA-IS),dynamic blood pressure parameters and quality of life were observed.Results In the walking exercise group,the FPG,HbA1c,FINS,HOMA-IR,HOMA-IS,dynamic blood pressure and quality of life indicators were all significantly different after 3 months of daily walking exercise compared with either baseline or the control group.Conclusion Accompanied by conventional drug therapy,10,000 steps/d of walking exercise can improve the glucose metabolism,dynamic blood pressure and quality of life of patients suffering from mild hypertension and type 2 diabetes.
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Objective To investigate the application value of virtual touch tissues quantization(VTQ)in the stages of type 2 diabetic nephropathy.Methods 120 cases of type 2 diabetes were divided into 3 groups according to urinary albumin excretion rate (UAER):diabetes without urinary albumin,diabetes with trace albuminuria and diabetes with mass albuminuria.The control group consisted 30 normal cases.VTQ was used to measure the renal shear wave velocity (SWV),then compare were made between the 4 groups.Besides,correlation analysis was made between SWV and UAER in diabetic nephropathy group.Results When compared SWV,there was no significant difference between diabetes without urinary albumin and control group (P =0.144),but there was significant difference between each 2 group of diabetes with trace albuminuria,diabetics with mass albuminuria group and control group (P ＜ 0.05).There was also significant difference between each 2 group of diabetes (P ＜ 0.05).The correlation coefficients for SWV and UAER in diabetes were 0.697(P ＜0.05).ROC analyses showed the area under curves for SWV diagnosis for diabetic nephropathy was 0.93.The best cutoff point,sensitivity and specificity were 2.43 m/s,85.7％ and 84.5 ％,respectively.Conclusions The renal SWV increases as the renal injury progresses,which also plays an important role in diabetic nephropathy stages.
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Objective To explore the value of virtual touch tissue quantification(VTQ) on the early diagnosis of gouty nephropathy.Methods 180 healthy controls and 109 gout patients including 57 cases with normal renal function,and 52 cases with gouty nephropathy were measured by VTQ in this study.The shear wave velocity (SWV) of renal cortex,renal medulla and renal sinus were measured using virtual touch tissue quantification(VTQ).The recorded SWV value was compared.Results In all groups,the SWV of renal cortex was the highest with significant difference (P ＜0.01).The SWV of renal cortex in gouty nephropathy group was higher than those in control group (t =0.342,P =0.026).The SWV of renal medulla and sinus in gout with normal renal function group and gouty nephropathy group were higher than those in control group,respectively (gout with normal renal function group:t =-0.311,-0.628; P =0.012,0.000;gouty nephropathy group:t =-0.369,-0.701 ; P =0.000,0.000).The SWV of renal cortex,medulla and sinus had no significant difference between gout patients with normal renal function and gouty nephropathy patients(t =0.117,-0.059,-0.073; P =0.232,0.575,0.523).Conclusions The VTQ technology could quantitatively evaluate tissue elasticity of the gout patients and provide evidence for the early diagnosis of gouty nephropathy.
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Objective To evaluate the significance of color Doppler ultrasound examination of renal blood flow combined with the detection of bone morphogenetic protein-7(BMP-7)in early diagnosis of type 2 diabetic nephropathy.Methods Blood BMP-7 level was tested in 90 patients with type 2 diabetic nephropathy and 30 controls,and parameters of renal blood flow were measured by color Doppler ultrasound examination.Blood BMP-7 level as well as resistant index(RI)of segmental renal artery(SRA)and interlobar renal artery(IRA),were compared between these two groups.Results Compared with controls,blood BMP-7 level gradually decreased with the aggravation of diabetic kidney damage(P＜0.01).The peak systolic velocity(Vmax)and the end diastolic velocity(Vmin)of SRA and TRA were slowed gradually,while RI increased(P＜0.01).Blood BMP-7 level was negatively correlated with IRA's and SRA's RI of IRA and SRA(r =-0.603,P＜0.01;r =-0.652,P＜0.01).Conclusions Color Doppler ultrasound examination of renal blood flow combined with detection of BMP-7 might play an important role in early diagnosis of type 2 diabetic nephropathy.
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Objective To evaluate the clinical value of multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging in diagnosing and staging bladder tumors.Methods Seventy-five patients were examined with three-dimensional ultrasound and two-dimensional ultrasound.In addition,54 cases were undergone preoperative multislice spiral CT.All cases were proved by pathology after operation.Results The qualitation accuracy in the diagnosis of bladder tumor with two-dimensional ultrasound was 93.3%(70/75) and that of three-dimensional ultrasound was 98.7%(74/75).The staging accuracy rates with two-dimensional ultrasound and three-dimensional ultrasound were 83.5%(106/127) and 93.2%(123/132) respectively.The difference of bladder tumor staging between three-dimensional ultrasound and two-dimensional ultrasound was significant (P＜0.05).The qualitation accuracy in the diagnosis of bladder tumor with CT was 90.7%(49/54).The preoperative staging rate of CT was 79.7%(59/74),compared with that of three-dimensional ultrasound,the difference was significant(P＜0.05).Conclusions Multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging can provide useful information and makes an improvement in detecting and staging bladder tumors.
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Objective To investigate the ultrasonographic characteristics of angiofollicular lymph node hyperplasia (AFH). Methods The ultrasonographic and pathological characteristics in nine patients with pathologically confirmed AFH were retrospectively analyzed. Results All the 9 patients were hyaline vascular type of AFH. Ultrasonic manifestations included complete capsule, regular shape and clear boundary, internal solide low echo, mild posterior echo enhancement and without cystic degeneration, which was relative to the less incidence of necrosis and hemorrhage on pathologic findings. Calcification in the lesions were found in two patients. Color Doppler flow signals were observed in the periphery of lesions in 9 patients, and rich flow signals were observed in the center of lesions in 2 of them. Conclusion The ultrasonic manifestations of AFH has its own characteristics. The ultrasonic manifestations combined with clinical features are helpful to the differential diagnosis. The final diagnosis depends on pathologic examination.
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Objective To evaluate the significance of homocysteine(HCY)and color Doppler flow imaging(CDFI)in the diagnosis and treatment of the renal damage in hypertension.Methods Seventy-two patients were divided into 3 groups according to the indicators of renal damage of hypertension.HCY in blood and the parameters of three grades renal artery with CDFI were measured and compared with 20 controls.Besides these，the relationship between HCY and resistant index(RI)of interlobar renal artery (IRA)was also analysed.Results①The level of HCY in hypertension was much more higher than the level in controls.HCY increased with the damage of renal function，and there were significant differences between different groups(P＜0.05).②The Vmax and Vmin were slower gradually，but PI and RI were higher with the severity of the renal damage(P＜0.01).③HCY were positive correlation with IRNs RI(r=0，35，P＜0.0 1).Conclusions The changes of CDFI can reflect the conditions of renal blood flow，it is possible to know renal blood flow by measuring RI of IRA.The level of HCY will increase gradually with the degression of renal function，it iS useful to evaluate the renal damage.The measurement of CDFI for hypertensive patients is valuable not only for the evaluations of their renal function but also for the severity of hyperhomocysteinemal and their therapy condition.
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BACKGROUND: Stem cell factors are hypoxia-induced neural regeneration factors. They stimulate animals' neural regeneration.OBJECTIVE: To observe Nestin and stem cell factor mRNA expressions after ischemia/reperfusion injury in rat brain, and to analyze the time rule of the two.DESIGN: A randomized controlled animal experiment.SETTING: Department of Ultrasound Diagnosis, Affdiated Hospital of Qingdao University Medical College.MATERIALS: Thirty-six healthy female adult Sprague-Dawley (SD) rats were provided by the Shanghai Laboratory Animal Center, Chinese Academy of Science. Nestin and stem cell factor mRNA in situ hybridization kits and 3,3'-diaminobenzidine (DAB)kit were provided by Boster Bioengineering Co.,Ltd (Wuhan, China).METHODS: This study was performed at the Shangdong Key Laboratory for Prevention and Treatment of Encephalopathy from January to June 2005. Thirty-two rats were created into models of ischemia/reperfusion models by occluding left middle cerebral artery with suture. At ischemia 1.5 hours and reperfusion 2, 6, 12, 24 hours, 2, 3, 7, 14 days, 4 rats were separately used in order to observe the expressions of Nestin and stem cell factor mRNA. The other 4 rats were used for sham-operation,in which, suture insertion was omitted, and the other procedures were identical to experimental groups. The expressions of Nestin and stem cell factor mRNA were detected in the cortex, corpora striatum and paraventricular nucleus region in rat brain by in situ hybridization.MAIN OUTCOME MEASURES: Nestin and stem cell factor mRNA expressions in the cortex, corpora striatum and paraventricular nucleus region in rat brain.RESULTS: Thirty-six rats were included in the final analysis. Nestin mRNA and stem cell factor were weakly expressed in the cortex, corpora striatum and paraventricular nucleus region in rats of sham-operation group. After ischemia/reperfusion, Nestin mRNA expression at each time point was significandy higher in the experimental groups (except in the cortex at ischemia 1.5 hours and reperfusion 2 hours, in the corpora striatum at ischemia 1.5 hours and reperfusion 2 and 6 hours and in the paraventricular nucleus region at ischemia 1.5 hours and reperfusion 2, 6 hours and 14 days) than in the sham-operation group (P＜0.05). While stem cell factor mRNA expression at each time point was significandy higher in the experimental groups (except in the cortex at ischemia 1.5 hours and reperfusion 2,6 and 12 hours, in the corpora striatum at ischemia 1.5 hours and reperfusion 2 and 6 hours and in the paraventricular nucleus region at ischemia 1.5 hours and reperfusion 2 hours and 14 days) than in the sham-operation group (P＜0.05).CONCLUSION: The time rule of stem cell factor mRNA expression is basically the same as that of neural stem cell proliferation. It indicates that following cerebral ischemia/reperfusion, stem cell factor mRNA expression may promote the proliferation of neural stem cells.
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Objective To evaluate the diagnostic value of localization and nature by ultrasonography in adrenal gland malignant tumors. Methods Adrenal gland malignant tumors were diagnosed by ultrasonography in 27 patients. Among them, 6 Cushing syndrome adenomas, 9 adrenogenital syndrome adrenocortical adenocarcinomas, 12 metastases were confirmed by surgery and pathology. Results There were differences in ultrasonographic appearances of 27 patients in adrenal gland malignant tumors with different pathology. Correctly diagnose was made in 26 patients for the localization by ultrasonography, and the accuracy was 96.3 %, while 25 patients were correctly diagnosed in nature and the accuracy was 92.6 %. Conclusions Ultrasonographic appearances of adrenal gland malignant tumors have some features, and ultrasonography is of great value in the localizing and qualitative diagnosing.
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Objective To evaluate the diagnosing and typing value of ultrasonography in adult congenital ureter cysts.Methods Ultrasonography findings were depicted of 29 cases with adult congenital ureter cysts confirmed by surgical and pathological examinations. Results In 29 cases of congenital ureter cyst, 14 occurred in right lateral, 12 in left lateral, and 3 in bilateral, totally being 32 cysts. The largest size of the cyst in diameter was (5.2) cm, and the smallest was (0.4) cm. Twenty-eight cases was diagnosed correctly by ultrasonography,in which the accuracy was (96.6)%(28/29). According to the sonographic patterns of size, shape, periodical change,1 case hydronephrosis, surgical and pathological results, 32 adult ureter cysts were divided into four types: type Ⅰ, papillary(12); type Ⅱ, round or ellipse(9);type Ⅲ, semilunar(4);and type Ⅳ, oblate(7). Conclusions Ultrasonographic appearance of adult ureter cyst is specific, and ultrasonography is of great value.
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Objective To investigate the effect of hysterectomy and uterine arterial embolization on the function of ovary.Methods The serum concentrations of estrin(E2), progestogen(P),fouicule-stimulating hormone(FSH),luteotropic hormone(LH) and prolaction(PRL) were measured in 18 patients undergone hysterectomy (group Ⅰ),15 patients undergone uterine arterial emboliation(group Ⅱ) and 30normal women (group Ⅲ or control group).These five hormones were compared in each group.Results The serum concentrations of E2 and P in the group Ⅰ were lower than that in group Ⅲ, there was significant difference between them.The serum concentrations of E2 and P in group Ⅱ and group Ⅲ was no significant difference.Conclusion Hysterectomy has significant effects on the function of ovary,while uterine arterial embolization has not.
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Objective To assess the value of ultrasound in evaluating clinical effect of treatment of hysteromyoma uterine by selective uterine artery embolization ( UAE ) .Methods 42 hysteromyoma uterine in 30 cases were examed by color doppler ultrasound befort and after uterine artery embolization with one year monthly.The size , morphology,internal echotexture and doppler signal of the uterus and myoma were observed , and the doppler signal of uterine artery , peripheral and interal vascular in myoma were measured . Results There was significant difference of the average colume of the uterus and its myoma between preoperation and postoperation ( 491.37 cm3 vs 236.75 cm3,102.33 cm3 vs 48.87 cm3 respectively,?