摘要
The medical insurance medical consumables were introuduced in terms of coding and standard implementation.A whole-process supervision method based on the codes of medical insurance medical consumbles was put forward to carry out catalog classification and selection,demand reporting and planned procurement,acceptance and storage management and use supervision,conditions monitoring and analysis and etc.The efficiency of various departments of clinical insitutitions was enhanced effectively for supervising clinical application of medical consumables,and the whole-process management of medical consumables was standardized.References were provided for the precision management of medical consumables.[Chinese Medical Equipment Journal,2023,44(9):74-77]
摘要
Objective:To study the value of CT texture analysis (CTTA) parameters in differential diagnosis of benign and malignant thyroid nodules in Hashimoto’s thyroiditis.Methods:From May. 2020 to Oct. 2021, 110 patients with thyroid nodules in the background of Hashimoto’s thyroiditis in the Radiology Department of Nanjing Integrated Hospital of Traditional Chinese and Western Medicine were selected, and CTTA was performed. CTTA parameters (entropy value, peak state and skewness) were counted. The pathological diagnosis results were taken as the "gold standard". Statistical pathological examination results were used to compare the general clinical characteristics and CTTA parameters of benign and malignant thyroid nodules. The receiver operating characteristic (ROC) was used to analyze the diagnostic value of CTTA parameters for thyroid nodules.Results:According to the clinicopathological examination, 43 of 110 patients with Hashimoto’s thyroiditis were malignant, accounting for 39.09%. Among them, 22 were papillary carcinoma, 13 were follicular carcinoma, 6 were medullary carcinoma, and 2 were malignant lymphoma; 67 cases were benign, accounting for 60.91%, including 32 nodular goiters, 20 Hashimoto’s nodules, 8 thyroid adenomas, and 7 focal inflammation. The levels of TSH, irregular shape, blurry border and calcification in patients with malignant thyroid nodules were higher than those in patients with benign thyroid nodules ( t/ χ2=13.167, 18.364, 20.180,17.621, P<0.001). In the background of Hashimoto’s thyroiditis, there was no significant difference in the peak and skewness of CTTA parameters between benign and malignant thyroid nodules ( t=1.633, 1.382, P=0.105, 0.170). The entropy value of patients with malignant thyroid nodules was higher than that of patients with benign thyroid nodules, and the difference was statistically significant ( t=9.862, P<0.001). ROC analysis showed that the cut-off value of entropy value for diagnosing benign and malignant thyroid nodules was 6.28, AUC value was 0.909, 95% CI was 0.839-0.955, sensitivity was 86.05% (37/43), and specificity was 88.06% (69/67) . Conclusion:CTTA parameters in Hashimoto’s thyroiditis patients with benign and malignant thyroid nodules are different, and CTTA parameters have certain diagnostic value for benign and malignant thyroid nodules.
摘要
Objective: Heavy metal and harmful element contamination are frequently reported in Chinese herbal medicines (CHMs), and roots and rhizomes parts showed a higher content than other parts. To investigate the residue level and assess the potential human health risk of heavy metals and harmful elements in roots and rhizomes, 720 batches of the sample representing 20 species of herbs from different sources were collected. Methods: The content of Pb, Cd, As, Hg, and Cu in the digests was determined using ICP-MS. The chronic hazard index estimate based on non-cancer hazard quotient (HQ) was applied for potential health risk assessment of Pb, Cd, As, Hg, and Cu via consumption of CHMs. Results: Compared with the Chinese limit standard (Chinese Pharmacopoeia Commission, 2020 edition) of Pb, Cd, As, Hg, and Cu in Ginseng Radix et Rhizoma, the exceedance percentage of Pb in total samples was 14.1%, which were generally far higher than Cd, As, Hg, and Cu. Health risk assessment results based on hazard quotient calculating showed that total HQ of Cu, Pb, As, Cd, and Hg in Pulsatillae Radix and Clematidis Radix et Rhizoma exceeded 1, with the value of 1.543 and 1.235. Besides, Arsenic had the highest HQ value (0.957) in Pulsatillae Radix. Conclusion: Consuming raw materials of Pulsatillae Radix and Clematidis Radix et Rhizoma may pose a potential risk and Arsenic residues in Pulsatillae Radix deserved special attention.
摘要
Objective To study the acromial angle morphologic type and measurement analysis based on CT 3D reconstruction. Methods Totally 278 cases of adult CT three-dimensional reconstruction of the shoulder morphological data were collected, and the measurement data of the different types was analyzed, its statistical significance was clarified, and the morphological characteristics to division the type of acromial angle were summarized, its diagnosis and treatment under the acromion impingement of guiding significance were discussed. Results The acromial angle was divided into three types (C shaped acromial angle, L shaped acromial angle, and double angle shaped acromial angle). Among them, L type was the most, accounting for 48. 56%, followed by C type, and double angle type was the least. In comparison of the breadth of the acromion and the length of the acromion, L type was significantly longer than C type (P<0. 05). The thickness of acromion at a point of the double angle shaped acromial angle was greater than that of the other two type (P<0. 05). In the comparison of ∠a, the double-angle type was greater than the C type(P<0.05), and the C type was greater than the L type(P<0.05). Conclusion There are significant differences in the classification and anatomical parameters of acromial angle, and the differences are statistically significant. It has certain guiding significance to the etiology and clinical diagnosis and treatment of subacromial impingement syndrome.
摘要
Objective:To explore the epidemiological characteristics and the antibiotic resistance of Streptococcus pneumoniae isolates, and to provide the evidence for the rational use of antimicrobial agents to treat Streptococcus pneumoniae infection. Methods:The positive microbiological laboratory identification and antimicrobial susceptibility testing of Streptococcus pneumoniae from sputum of children with respiratory infections during January 2010 to December 2017 in Children′s Hospital of Soochow University were retrospectively analyzed. The positive rates of Streptococcus pneumoniae of different genders, ages, years and seasons were compared. The annual detection rates and trends of drug resistance of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were analyzed by Mann-Kendall trend test. The seasonal decomposition of time series was conducted to assess the association between Streptococcus pneumoniae detection rate and season. Enumeration data was compared using χ2 test. Results:Of the 88 480 sputum specimens, the total positive rate of Streptococcus pneumoniae was 10.3%(9 081/88 480). The detection rates of Streptococcus pneumoniae in children aged 0 to <0.5 years old, 0.5 to <2 years old, 2 to <3 years old, 3 to <5 years old, and 5 to <15 years old were 4.2%(1 407/33 224), 13.1%(3 191/24 390), 14.9%(2 417/16 252), 17.9%(1 474/8 246) and 9.3%(592/6 368), respectively. The difference was statistically significant ( χ2=2 421.6, P<0.01). The detection rates were 8.1%(1 321/16 306) from January to March, 10.9%(2 194/20 207) from April to June, 8.5%(2 141/25 058) from July to September, and 12.7%(3 425/26 909) from October to December. The discrepancy of positive rates in different seasons showed statistical significance ( χ2=311.5, P<0.01). During 2010 to 2017, significant decreases in antibiotic resistant rates of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were detected (tau=-0.93, -0.93 and -0.71, respectively, all P<0.05). Conclusions:The detection rate of Streptococcus pneumoniae in sputum of children with respiratory infections may present seasonal pattern and vary between different ages of children. The resistance to β-lactam antibiotics has declined.
摘要
Objective To study the effect of AIDS intervention programs among college students, and to provide fundamental support for the formulating of AIDS prevention strategies. Methods A cluster sampling methods was used to conduct a longitudinal follow-up survey among 2 000 freshmen from four colleges in Yantai in 2016, The knowledge, attitudes and behaviors related to AIDS were analyzed by generalized estimating equation analysis method. We also conducted in-depth personal interviews among university leaders. Results The awareness rate of AIDS among young students in Yantai was 70.4%, 85.9%, and 95.8%, respectively. The generalized estimating equation showed that the total awareness rate of AIDS knowledge increased year by year (Z=-23.42, P<0.001). The occurrence of different types of sexual behaviors maintained at a low level, and no obvious trend changes were observed. Multivariate Logistic regression showed that a high occurrence of sexual behaviors among young college students was found related to male, poor knowledge of AIDS prevention, having not received public services related to AIDS prevention, and having not participated in public services related to AIDS prevention (all P<0.05). Interview results showed that, three of the four colleges have included AIDS health education into their teaching plans, and the AIDS epidemic notification system has been fully implemented. Conclusions The awareness rate of AIDS knowledge among college freshmen in Yantai is relatively low. Implementing comprehensive intervention measures and establishing a multi-sectoral cooperation mechanism are the most effective measures to improve the knowledge of AIDS prevention, and promote safe sexual behaviors among young college students.
摘要
The study was aimed to determine the efficacy of two pesticides in the control of aphids in Lonicera japonica, and study the applicability of pesticides in L. japonica. The number of insects was counted before and 2, 3, 7 and 10 days after the application of pesticide in the test area within different dosage groups. The method was 5-point sampling method. Five aphids on the L. japonica branches were selected, then the number of insects was recorded. The effect of the two pesticides on the control rate of aphid was more than 80% at 1 d after application. The results showed that the two pesticides had good efficacy. After 7 days and 10 days, the control effect was 100%. After 1 day of spraying, the effect of the two pesticides on the control of L. japonica aphids was more than 80%, which was higher than that of the control agent. The results showed that the two pesticides had good and fast effect. After 7 days and 10 days of spraying, the control effect was 100%. The control effect of two kinds pesticides for aphid sprayed in recommended dose on the L. japonica is good and showed no hytotoxicity.
Subject(s)
Animals , Aphids , Lonicera , Niacinamide , Pesticides , Pyridines , Sulfur Compounds摘要
This paper reports the residual status of forbidden and restricted pesticides of organophosphorus in Loincerae Japonicae Flos to provide reference for the risk control and the formulation of maximum residue limits of the flower. A method for the determination of residues of 23 forbidden and restricted pesticides of organophosphorus was established, and 64 collected samples were tested. Then a risk assessment based on the maximum residue limit was carried out. Results showed that the detection rate of samples was 58%. 6 of 23 pesticides were detected and the ratio was chlorpyrifos 41%, omethoate 23%, triazophos 11%, isofenphos-methyl 6.3%, methamidophos 1.6%, isocarbophos 1.6%, respectively. And the median of pesticide residues in the positive samples was chlorpyrifos 0.037 mg·kg⁻¹, omethoate 0.043 mg·kg⁻¹, triazophos 0.030 mg·kg⁻¹, isofenphos-methyl 0.18 mg·kg⁻¹, methamidophos 0.041 mg·kg⁻¹, isocarbophos 0.041 mg·kg⁻¹, respectively. In the samples with pesticide residues, the residue amount of methamidophos and isocarbophos was lower than the theoretical maximum residue limit, and the residue amount of chlorpyrifos, isofenphos-methyl, triazophos were higher than it individually, while, all the residue amount of omethoate was higher than it. According to the assessment result of theoretical maximum residue limit, it is suggested that relevant departments should accelerate the formulation of the maximum residue limit standard, and strengthen the supervision of the use of forbidden and restricted pesticides of organophosphorus in Loincerae Japonicae Flos.
摘要
Objective:To determine the expression of syntaxin 8 in gastric carcinoma and its clinical significance.Methods:To determine the expression levels of syntaxin 8 in gastric carcinoma and pericancerous stomach tissues of 62 patients with gastric carcinoma by immunohistochemistry,western blot.Results:Results of immunohistochemistry and western blot showed that the expression of syntaxin 8 was significantly higher than that in the adjacent pericancerous stomach tissues,and syntaxin 8 is negative in most normal tissues.The difference was statistically significant (P<0.05).Correlation analysis found that the high expression of syntaxin 8 in gastric carcinoma tissue was not significantly related to gender,age,tumor size,TNM stage,invasion and metastasis of gastric carcinoma,but the higher expression rate was up-regulated in gastric carcinoma with distant metastasis.Conclusion:Syntaxin 8 is abnormal high expression in gastric carcinoma tissues,and is related to the occurrence and development of gastric carcinoma.It may also be a potential target for gastric carcinoma diagnosis and treatment.
摘要
Objective:To determine the expression of syntaxin 8 in gastric carcinoma and its clinical significance.Methods:To determine the expression levels of syntaxin 8 in gastric carcinoma and pericancerous stomach tissues of 62 patients with gastric carcinoma by immunohistochemistry,western blot.Results:Results of immunohistochemistry and western blot showed that the expression of syntaxin 8 was significantly higher than that in the adjacent pericancerous stomach tissues,and syntaxin 8 is negative in most normal tissues.The difference was statistically significant (P<0.05).Correlation analysis found that the high expression of syntaxin 8 in gastric carcinoma tissue was not significantly related to gender,age,tumor size,TNM stage,invasion and metastasis of gastric carcinoma,but the higher expression rate was up-regulated in gastric carcinoma with distant metastasis.Conclusion:Syntaxin 8 is abnormal high expression in gastric carcinoma tissues,and is related to the occurrence and development of gastric carcinoma.It may also be a potential target for gastric carcinoma diagnosis and treatment.
摘要
Objective To investigate the correlations of altitude and duration on the plateau with the heart rate and oxygen saturation of young males.Methods A total 483 cases of males garrisoned on the plateau were enrolled.Informa-tion on age, underlying diseases, length of service on the plateau and garrison areas was collected.The heart rate and oxygen saturation were measured,and the correlations of altitude and duration on the plateau with the heart rate and oxygen saturation were analyzed.Results There was no statistically significant difference in oxygen saturation between the group stationed on the plateau for more than 6 years and the group stationed for less than 6 years.There was significant difference in blood oxygen saturation and heart rate between the two groups.Oxygen saturation was negatively correlated with altitude. Heart rate was positively correlated with altitude.Conclusion Young males who are stationed more than 4500 m above sea level are at high risk of chronic high altitude disease.The risk of chronic high altitude disease can increased with the length of service and age,but further confirmation is meeded.
摘要
BACKGROUND:To inhibit the expressions of prothrombin activator inhibitor 1 and tissue plasminogen activator is one potential target for the treatment of cerebral infarction. OBJECTIVE:To investigate the expressions of serum inflammatory cytokines in rats with cerebral infarction undergoing bone marrow mesenchymal stem cel transplantation combined with edaravone. METHODS:Sixty Sprague-Dawley rats were enrol ed to prepare models of focal cerebral infarction by middle cerebral artery occlusion, and were randomly divided into four groups. Rats were given intravenous injection of PBS via tail veins for 5 consecutive days as model group, rats were subjected to intravenous injection of 2.0×109/L bone marrow mesenchymal stem cel suspension (1 mL) via tail veins, twice daily for 5 days as stem cel transplantation group, and those were given intravenous injection of 30 mg edaravone combined with intravenous injection of 2.0×109/L bone marrow mesenchymal stem cel suspension (1 mL) via tail veins for 5 days, twice daily, as combined group. RESULTS AND CONCLUSION:Compared with the model group, modified neurologic severity scores were lower, expressions of serum prothrombin activator inhibitor 1 and tumor necrosis factor-αmRNA in the brain decreased, and the infarct area reduced in the stem cel transplantation and combined groups. And the changed levels of above indicators in the combined group were significantly larger than those of the stem cel transplantation group. In conclusion, combination of bone marrow mesenchymal stem cel transplantation with edaravone can promote neural function recovery after cerebral infarction.
摘要
This paper reports the residual dynamics of deltamethrin and detection method in Loincerae Japonicae Flos to provide scientific basis for safe and appropriate use of deltamethrin. A field experiment was conducted in Fengqiu, Henan Province China. The field plots were sprayed with deltamethrin at the recommended dose and a high dose, respectively, and a control was set up, totally being 3 treatments with 3 replications. The flowers were picked at 2 hours, 1, 2, 3, 4, 5, 7, 9, 11, 13 and 15 days after pesticide application and then dried. The residue of deltamethrin was determined by gas chromatography method with electron capture detector for the above samples. Results showed that recoveries of deltamethrin ranged from 76.4% to 86.9%,and the relative standard deviation was below 11%,Linearity was observed over a range of 5-500 μg•L ⁻¹ with correlation coefficient was 0. 999 2. The established method meets the requirements of pesticide residue analytical methods. The degradation of deltamethrin followed the first order dynamics. The residue dynamic equation of the high dose and recommended dose deltamethrin were C=5.992 2e-0.338t and C=1.536 9e-0.31t respectively, and the half-life of deltamethrin in Loincerae Japonicae Flos was 2.09-2.24 days, which indicates that deltamethrin is an easily degradable pesticide. It is concluded that deltamethrin should be used in aphids occurring period and the safety interval was more than 7 days to ensure the safety of Loincerae Japonicae Flos consuming.
摘要
Objective To explore the clinical value of urethral dilation in treatment of female bladder outlet obstruction. Methods Thirty-five female bladder outlet obstruction patients were selected, and all the patients failed for more than 1 month inαreceptor blocker treatment. The patients underwent urethral dilation under local anaesthesia, once a week, for a total of 12 times. The international prostate symptom score (IPSS), quality of life score (QOL) and residual urine volume before and after treatment were examined. Results The IPSS, QOL and residual urine volume after treatment were significantly lower than those before treatment: (10.23 ± 6.31) scores vs. (21.41 ± 3.71) scores, (2.31 ± 0.65) scores vs. (5.43 ± 0.60) scores and (20.73 ± 10.59) ml vs. (85.23 ± 12.15) ml, and there were statistical differences (P<0.01). Conclusions The urethral dilation is one of the effective treatments for female bladder outlet obstruction patients who fail in αreceptor blocker treatment. It can make a part of patients avoid invasive examination and surgery, and it is worth to be popularized in clinic and primary hospital.
摘要
BACKGROUND:Studies have shown that human telomerase reverse transcriptase (hTERT) has the ability to enhance cel proliferation, maintain telomere length, prolonged cel life cultured in vitro. OBJECTIVE:To observe the effect of hTERT gene-modified bone marrow mesechymal stem cel transplantation on neural function recovery of rats with cerebral infarction. METHODS:Rat models of middle cerebral artery occlusion were established and randomized into model group, cel transplantation group and hTERT-modified cel transplantation group, with 20 rats in each group. Rats in the three groups were respectively injected via tail vein with 1 mL PBS, passage 9 bone marrow mesenchymal stem cel suspension (2.5×107/L) and hTERT-modified passage 9 bone marrow mesenchymal stem cel suspension (2.5×107/L), respectively. Modified neurological severity scores were determined before and after transplantation; RT-PCR and western blot assay were used to measure hTERT expression at gene and protein levels; TUNEL method was adopted to detect cel apoptosis in the brain. RESULTS AND CONCLUSION:hTERT-modified bone marrow mesenchymal stem cels had prolonged cel cycle, and with the increase in passage number, the cels showed good growth with no changes in morphology. The expressions of hTERT mRNA and protein were superior in the hTERT-modified cel transplantation group than the cel transplantation group, and there was a significant difference (P < 0.05). Modified neurological severity scores and number of apoptotic cels were decreased significantly in the hTERT-modified cel transplantation group compared with the other two groups (P < 0.05). These findings indicate that hTERT-modified bone marrow mesenchymal stem cels can promote neural functional recovery of rats with cerebral infarction.
摘要
Objective To evaluate the value of the four kinds of diagnostic method in acquired immune deficiency syndrome (AIDS) infection complicating tuberculosis (TB) .Methods 52 cases of human immunodeficiency virus (HIV) infection complica‐ting TB were taken as the observation group and 100 cases of TB without complicating HIV infection were taken as the control group .The two groups were performed the PPD test ,sputum Mycobacterium tuberculosis culture ,tuberculosis antibody and inter‐feron gamma release assay(IGRA) for conducting the diagnosis .Results The positive rate of the PPD test ,sputum Mycobacterium tuberculosis culture and tuberculosis antibody in the control group were significantly higher than those in the observation group ,the differences were statistically significant (P<0 .01);the positive rate of the IGRA in the observation group was obviously higher than that of the PPD test ,sputum Mycobacterium tuberculosis culture and tuberculosis antibody ,the differences had statistical sig‐nificance (P<0 .01) .The negative occurrence rate of the IGRA in the observation group treated by the antiretroviral therapy was obviously higher than the positive rate ,the difference was statistically significant (P<0 .05) .Conclusion The IGRA may be a sen‐sitive method for diagnosing HIV infection complicating TB and the antiretroviral therapy may have a certain impact on the results .
摘要
BACKGROUND:Numerous clinical studies have confirmed that the microenvironment at a spinal cord injury site can be obviously improved through hyperbaric oxygen therapy; however, what effect does hyperbaric oxygen have on the microenvironment of the injured brain? OBJECTIVE:To investigate the effect of hyperbaric oxygen therapy on nerve regeneration microenvironment and the recovery of rat nerve function after focal cerebral infarction. METHODS:Rat models of focal cerebral infarction were established by occlusion of the middle cerebral artery and subjected to hyperbaric oxygen therapy. Sham group and model group were established as comparison. In the sham group, rat models of focal cerebral infarction were established but did not receive any treatment. Rats in the model group were placed in a hyperbaric oxygen therapy chamber but the pressure and oxygen concentration were not administered. RESULTS AND CONCLUSION:Compared with the model group, the score of rat limb function at 16 days after treatment and the expression of growth associated protein 43 in the rat cerebral infarcted area at postoperative 14 days were significantly increased , but infarct volume at postoperative 24 hours was al significantly decreased in the hyperbaric oxygen therapy group (alP < 0.05). These results confirmed that hyperbaric oxygen therapy can improve nerve regeneration microenvironment and promote the recovery of rat nerve function after focal cerebral infarction.
摘要
BACKGROUND:Gene transfer techniques have been actively used in tissue regeneration therapy. Bone morphogenetic protein 7 with osteoinductive properties can effectively promote osteoblast growth and new bone formation. OBJECTIVE:To explore the influence of bone morphogenetic protein 7 adenovirus gene transfection on the biological function of bone marrow stromal stem cels.METHODS:Goat bone marrow stromal stem cels were isolated, cultured and transfected by recombinant adenovirus containing bone morphogenetic protein 7 (Adeno-BMP7). Cel ultrastructure was observed by transmission electronic microscope, cel cycle was detected by flow cytometry, expression of bone morphogenetic protein 7 was measure by western blot assay, and Von Kossa staining was used to observe the formation of calcium nodules. Bone marrow stromal stem cels transfected for 3 days and untransfected were used to prepare coral-cel complexes that were injected subcutaneously into the back of nude mice for 4 weeks and 8 weeks, folowed by gross observation and histological examination. RESULTS AND CONCLUSION: Adeno-BMP7-transfected bone marrow stromal stem cels appeared to have active substance synthesis and metabolism. Adeno-BMP7 transfection played no effect on the cel cycle of bone marrow stromal stem cels. Bone morphogenetic protein 7 was expressed in the transfected bone marrow stromal stem cels. Larger calcium nodules were visible after Adeno-BMP7 transfection. Adeno-BMP7-transfected bone marrow stromal stem cels showed stronger osteogenic capability and higher bone quality. These results demonstrate that Adeno-BMP7 transfection can effectively promote the osteogenic differentiation of bone marrow stromal stem cels.
摘要
PURPOSE: In the present study, we investigated the incidence of cardiotoxicity within 5 years of trastuzumab treatment and evaluated potential risk factors in clinical practice. METHODS: The study cohort included 415 patients diagnosed with early breast cancer (EBC). Cardiotoxicity incidence was evaluated in patients receiving trastuzumab and those who did not. Multivariate Cox proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals of potential risk factors for trastuzumab-related cardiotoxicity after appropriate adjustments. RESULTS: Incidence of cardiotoxicity in patients treated with trastuzumab was significantly higher than that in controls (23.7% vs. 10.8%, p<0.001). This result was adjusted for factors that might increase the risk of cardiotoxicity, such as history of coronary artery diseases or the use of anthracyclines for more than four cycles. CONCLUSION: Our findings indicated that treatment with trastuzumab was strongly associated with cardiotoxicity in EBC patients.
Subject(s)
Humans , Anthracyclines , Breast Neoplasms , Cohort Studies , Coronary Artery Disease , Incidence , Observational Study , Prospective Studies , Risk Factors , Trastuzumab摘要
Human infections with Lophomonas blattarum are rare. However, the majority of the infections occurred in China, 94.4% (136 cases) of all cases in the world. This infection is difficult to differentiate from other pulmonary infections with similar symptoms. Here we reported a case of L. blattarum infection confirmed by bronchoalveolar lavage fluid smear on the microscopic observations. The patient was a 21-year-old female college student. The previous case which occurred in Chongqing was 20 years ago. We briefly reviewed on this infection reported in the world during the recent 20 years. The epidemiological characteristics, possible diagnostic basis, and treatment of this disease is discussed in order to provide a better understanding of recognition, diagnosis, and treatment of L. blattarum infection.