Characteristics analysis of delayed hospital visits in elderly tuberculosis patients in Anji County， Zhejiang Province / 上海预防医学

ObjectiveTo characterize delayed visits of elderly patients with tuberculosis aged ≥60 years in Anji County， Zhejiang Province from 2010 to 2021， and to provide evidence for the prevention and control of tuberculosis in elderly population. MethodsData of elderly patients with tuberculosis in Anji County from 2010 to 2021 were collected through the Tuberculosis Management Information System of National Information System for Disease Control and Prevention. Multivariate logistic regression model was used to determine the influencing factors of delayed visits. ResultsA total of 1 191 cases of elderly tuberculosis were reported in Anji County from 2010 to 2021， with an average annual incidence of 112.43/105， showing a decreasing trend （χ2trend=11.297， P=0.001）. The male-to-female ratio was 2.29∶1， the active detection rate was 0.34%， and the pathogen-positive rate was 50.63%. There were 718 cases of delayed hospital visits， with a median delay time of 19 days and a delayed visit rate of 60.29%， showing an increasing trend （χ2trend=6.651， P=0.01）. Multivariate logistic regression analysis showed that local household registration status was a risk factor affecting the delayed visits for elderly tuberculosis patients （OR=1.944， 95%CI：1.388‒2.729）. ConclusionThe elderly patients with tuberculosis are a key population for tuberculosis prevention and control. It is necessary to strengthen early diagnosis and treatment， improve the active detection rate， reduce delayed hospital visits， so as to lower the risk of community transmission.

Development and clinical application of a rapid and sensitive loop-mediated isothermalamplification test for SARS-CoV-2 infection

BackgroundThe SARS-CoV-2 outbreak urgently requires sensitive and convenient COVID-19 diagnostics for the containment and timely treatment of patients. We aimed to develop and validate a novel reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay to detect SARS-CoV-2 in qualified laboratories and point-of-care settings. MethodsPatients with suspected COVID-19 and close contacts were recruited from two hospitals between Jan 26 and April 8, 2020. Respiratory samples were collected and tested using the RT-LAMP assays, and the results were compared with those obtained by RT-qPCR. Samples yielding inconsistent results between these two methods were subjected to next-generation sequencing for confirmation. The RT-LAMP assay was also tested on an asymptomatic COVID-19 carrier and patients with other respiratory viral infections. ResultsSamples were collected from a cohort of 129 cases (329 nasopharyngeal swabs) and an independent cohort of 76 patients (152 nasopharyngeal swabs and sputum samples). The RT-LAMP assay was validated to be accurate (overall sensitivity and specificity: 88.89% and 99.00%; positive and negative predictive values: 94.74% and 97.78%, respectively) and diagnostically useful (positive and negative likelihood ratios: 88.89 and 0.11, respectively). RT-LAMP showed an increased sensitivity (88.89% vs 81.48%) and high consistency (kappa 0.92) compared with RT-qPCR for SARS-CoV-2 screening while requiring only constant temperature heating and visual inspection. The time required for RT-LAMP was less than 1 h from sample preparation to result. In addition, RT-LAMP was feasible for use with asymptomatic patients and did not cross-react with other respiratory pathogens. ConclusionThe developed RT-LAMP assay offers rapid, sensitive and straightforward detection of SARS-CoV-2 infection and could aid the expansion of COVID-19 testing in the public domain and hospitals.

Clinical application in the rapid diagnosis of urinary tract infection / 中华检验医学杂志

Objective To explore the value of UF-5000 urinary sediment analyzer in assistant examination of urinary tract infections by comparing the results of bacteria and white blood cells for UF-5000 with those of routine laboratory methods.Methods A total of 1 021 clean mid-stage urine samples suspected urinary tract infection were collected from the inpatients and outpatients of the Guangdong Provincial People's Hospital from October to December 2017.All specimens were detected by UF-5000 to evaluate the repeatability,linearity,carrying contamination rate,stability and efficiency of review flag by the instrument.Urine bacterial culture and clinical diagnosis were used as reference standards to calculate the coincidence rate of bacterial test results with purified bacteria,coincidence rate with bacterial culture,and agreement rate with cultured colonies.The urinary fungal culture and clinical diagnosis were used as reference standards to calculate the coincidence rate,sensitivity and specificity of the fungal test.Based on the results of bacterial culture and clinical diagnosis,UF-5000 was used to detect the efficacy of white blood cells and bacteria for the diagnosis of UTI.The results of UF-5000 detection,the results of urinary dry chemistry analyzer UC-3500,and the results of bacterial smear microscopy were compared with the results of urinary bacterial culture to determine the sensitivity,specificity and sensitivity of each method,and the coincidence rate of with the culture method.Statistical analysis was performed using variance analysis,Wilcoxon rank sum test,coincidence rate test (Kappa test),and receiver operating characteristic curve (ROC curve).Results UF-5000 was used to detect bacteria and white blood cells,UC-3500 was used to detect neutrophil esterase and nitrite with good repeatability,which met the EP5-A requirements;the linear relationship between bacteria was very good in the range of 0-10 000/ml,R=0.999;the contamination rate of UF-5000 was 0.00％ for bacteria,0.01％ for white blood cells.The rate of UC-3500 was qualified;the bacteria was stable for 2 hours at room temperature and 6 hours at 4 ℃,and the white blood cells were stable for 4 hours at room temperature and 4 hours at 4 ℃.Compared with UF-1000i,the review flag rate of UF-5000 reduced about 77.8％.The coincidence rate of detection and purification of UF-5000 bacteria was 100.0％(16/16),that of Gram-negative bacteria (G-) was 94.0％ (110/117),that of Gram-positive bacteria (G+) was 82.2％(37/45).The agreement rate of compared with bacterial colonies was 95.1％(216/227),and that of fungi culture was 77.1％ (749/972),that of sensitivity was 81.9％(118/144),and that of specificity was 76.2％(631/828).UF-5000,UC-3500,and bacterial smear microscopy showed that the ability of bacterial infection of urinary tract was compared with the results of traditional bacterial culture.The UF-5000 urinary tract infection flag (UTI) had the highest agreement rate,reaching 84.1％ (180/214).The sensitivity was 70.3％ (52/74),the specificity was 91.4％ (128/140);the coincidence rate of UC-3500 was 73.8％ (158/214),the sensitivity was 25.7％ (19/74),and the specificity was 99.3％ (139/140);the consistency of bacterial smear microscopy was 66.4％ (142/214),the sensitivity was 82.4％ (61/74),and the specificity was 57.9％ (81/140).Conclusion The total number of bacteria and white blood cell counted by UF-5000,the flag of bacterial and the UTI information,have partial clinical significance in the rapid detection of urinary tract infection.

Investigation of SLC26A4 mutations associated with inner ear malformations / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the molecular pathogenesis of SLC26A4 mutations associated with inner ear malformations including large vestibular aqueduct syndrome (LVAS), Mondini dysplasia and inner ear malformations but not accompanied with LVAS.@*METHOD@#DNA sample and clinical material were obtained from 14 sporadic LVAS probands, six Mondini dysplasia probands and seven inner ear malformations excluding IVAS probands. SLC26A4 gene mutation was analyzed by direct sequencing for its 20 coding exons. GJB2 gene and also mt12SrRNA were analyzed by direct sequencing.@*RESULT@#In 14 cases of LVAS, two mutations were detected in 12 patients (85.7%, either homozygous or compound heterozygous mutations), and one mutation was found in two patients (14.3%). In six cases of Mondini dysplasia, two mutations were detected in all of patients (100%). No mutation could be found in the seven cases of other inner ear abnormalities not accompanied with LVAS. No pathogenic mutation was detected in all of these 27 probands in GJB2 gene and mt12SrRNA 1555/1494T.@*CONCLUSION@#We have shown that LVAS and Mondini dysplasia closely correlate with SLC26A4 gene. No mutation was detected in seven probands of inner ear malformations not accompanied with LVAS. We should study the molecular pathogenesis of this disease in depth.

Experiential Learning of Undergraduates——“SHU TU TONG GUI” Activity Series / 中华医学教育探索杂志

Focusing on the individual ability and the current domestic higher education,we were trying to set up a new learning pathway,experiential learning.Under performing a"SHU TU TONG GUI"activity series,undergraduates were encouraged to develop their cooperative skill and creativity quality.This exploration was helpful for us to carry out a new higher education mode in the future.

Changes of hearing and cochlear morphology in rats with cerebral concussion / 中国耳鼻咽喉头颈外科

0.05). The morphological changes were observed in the cochlea. Moreover, the changes of cochlear tissues under the optical microscope wasa lot of akaryotes were found in the blood capillary of cartilaginous tissue in the rats of 30 minutes after rammed; a great quantity inflammatory cells were observed in the blood capillary of cartilaginous tissue in the rats of 1 day rammed. The changes of morphology coincided with the results of DPOAE. CONCLUSION Outer hair cells may be injured by cerebral concussion and the changes were showed by DPOAE and ABR.

Effect of combination of Ginkgo leaf extract and deferoxamine in preventing and treating ototoxicity of cisplatin / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of combined use of jinnaduo (an injection made by extract of Ginkgo leaf, EGb) and Deferoxamine (DFO, a chelating agent) in antagonizing the ototoxicity of cisplatin (CDDP).</p><p><b>METHODS</b>Guinea pigs were randomly divided into the CDDP group, the EGb group, the DFO group, the combined treated group (EGb + DFO) and the control group. Changes of auditory brain-stem response (ABR), serum superoxide dismutase (SOD) activity and malondialdehyde (MDA) content, as well as light and scanning electronic microscopic (SEM) figures were observed before and after treatment.</p><p><b>RESULTS</b>The threshold of ABR was significantly higher in the CDDP group than that in the other groups (P<0.01), but was insignificantly different among the latter groups (P>0.05). Serum SOD activity was lower and MDA content was higher in the CDDP group than those in the control group (P<0.01), but in comparison of the two parameters between control and other groups, the difference was insignificant (P>0.05). SEM examination on cochlea showed that the damage of hair cells was milder in the DFO group and the combined treated group than that in the CDDP group, which was slightly milder in the EGb group than that in the CDDP group.</p><p><b>CONCLUSION</b>Combined use of EGb and DFO could effectively reduce the ototoxicity of CDDP, its effect is better than using EGb singly, and similar to that of using DFO alone. The combination could also prevent the side-effect of CDDP in bone marrow inhibition. The Fe ion participated free radical response could be one of the mechanisms of CDDP in damaging hearing.</p>