Objective:To investigate the diagnostic value of nucleic acid matrix-assisted laser desorption ionization-time of flight mass spectrometry（MALDI-TOF MS）in sputum smear-negative patients with nontuberculous Mycobacterial（NTM）pulmonary disease.Methods:Clinical data of 123 patients suspected of NTM pulmonary disease admitted in Public Health Clinical Center Affiliated to Shandong University between July 2022 and November 2023 were retrospectively analyzed. Bronchoalveolar lavage fluid（BALF）specimens were collected for MALDI-TOF MS assay and MGIT 960 culture. The diagnostic efficacy of MALDI-TOF MS for NTM pulmonary disease in patients with negative sputum smears for acid-fast bacilli was evaluated with receiver operating characteristic（ROC）curve. Statistical analysis was performed using SPSS 26.0 software and MedCalc statistical software.Results:Diagnosis of NTM pulmonary disease was finally confirmed in 66 out of the 123 suspected patients. It took 8 to 24 h for MALDI-TOF MS to identify NTM species and resistance. By MALDI-TOF MS，72 NTM strains were identified，with the Mycobacterium avium complex being the most prevalent（34 strains，47.22%），followed by the Mycobacterium abscessus complex（13 strains，18.06%）；resistance to macrolides was detected in 6 cases，while no resistance to aminoglycosides was found. It took 9 to 45 days for BALF MGIT 960 culture to identify NTM，and took 7 to 15 days for NTM typing and drug sensitivity testing. By BALF MGIT 960 culture，28 NTM strains were identified；and 1 case was found to be resistant to macrolides. Using confirmed diagnosis as the gold standard，MALDI-TOF MS demonstrated higher sensitivity，negative predictive value，and agreement rate compared to MGIT 960 culture（84.85% vs. 42.42%，81.13% vs. 56.32%，80.49% vs. 62.60%， χ2=25.667，8.998，9.664， P<0.05 or <0.01）. The area under ROC curve（AUC）for MALDI-TOF MS was significantly higher than that of MGIT 960 culture（0.801 vs. 0.642， Z=3.300， P=0.001）. Conclusion:Compared to MGIT 960 culture，MALDI-TOF MS exhibits superior diagnostic efficiency in detecting NTM pulmonary disease in patients with acid-fast bacilli smear-negative sputum，with advantage of rapidly identifying NTM species and resistance.

Objective To analyze the screening results of tumor markers carbohydrate antigen 724 (CA-724), carbohydrate antigen 153 (CA-153), carbohydrate antigen 125 (CA-125), carbohydrate antigen 199 (CA-199) and carcinoembryonic antigen (CEA) in the 45 ~ 60-year-old health examination population in Chengdu area. Methods A total of 2 268 healthy people aged 45 ~ 60 years old living in Chengdu area from May 2019 to August 2020 were selected. Levels of serum tumor markers CA-724, CA-153, CA-125, CA-199 and CEA were detected by electrochemiluminescence. Positive rates of different tumor markers and confirmed diagnosis of malignant tumors were statistically analyzed. People with positive and negative tumor markers were respectively included in the positive group and the negative group, and their serum tumor markers were compared. The screening results of tumor markers in the health examination population of different gender and age, and the diagnostic efficiency of each tumor marker for malignant tumors were analyzed. Results Among the 2 268 healthy people, the positive rates of CA-724, CA-153, CA-125, CA-199 and CEA were 10.05%, 4.98%, 1.10%, 7.01% and 4.76%, respectively. A total of 72 cases were positive for tumor marker detection, with a total positive rate of 3.17% (72/2,268). Among them, 12 cases were diagnosed as early or mid-term tumors by pathology, imaging and other examinations, with a total tumor detection rate of 0.53% (12/2,268), including 8 cases of malignant tumors, with a detection rate of 0.35% (8/2,268). The levels of CA-724, CA-153, CA-125, CA-199 and CEA in the tumor markers positive group were higher than those in the negative group (P<0.05). The CA-125 and CA-199 positive rates in males were lower than those in females, while CEA positive rate was higher in males than in females (P<0.05). Positive rates of CA-153, CA-199 and CEA in different age groups showed statistically significant differences (P<0.05). Positive expression of CA-153 and CA-199 mainly occurred in the 51~60 years old group, and positive expression of CEA mainly occurred in the 45~50 years old group. ROC curve analysis showed that combined detection of CA-724, CA-153, CA-125, CA-199 and CEA had the highest sensitivity, specificity and accuracy in predicting malignant tumors, and the area under the curve was the largest (0.865). Conclusion Tumor markers CA-724, CA-153, CA-125, CA-199 and CEA are highly expressed in the 45 ~ 60-year-old health examination population in Chengdu area, and positive rate of CA-724 is the highest. Levels of tumor markers in people of different gender and age are also different. Joint detection of various tumor markers is conducive to early detection and treatment of the disease, and reduction of deterioration risk.

OBJECTIVETo investigate the changes in red blood cell count in patients with different liver diseases and the correlation between red blood cell count and degree of liver damage.

METHODSThe clinical data of 1427 patients with primary liver cancer, 172 patients with liver cirrhosis, and 185 patients with hepatitis were collected, and the Child-Pugh class was determined for all patients. The differences in red blood cell count between patients with different liver diseases were retrospectively analyzed, and the correlation between red blood cell count and liver function status was investigated. The Mann-Whitney U test, Kruskal-Wallis H test, rank sum test, Spearman rank sum correlation test, and chi-square test were performed for different types of data.

RESULTSRed blood cell count showed significant differences between patients with chronic hepatitis, liver cancer, and liver cirrhosis and was highest in patients with chronic hepatitis and lowest in patients with liver cirrhosis (P < 0.05). In the patients with liver cirrhosis, red blood cell count tended to decrease in patients with a higher Child-Pugh class (P < 0.05).

CONCLUSIONFor patients with liver cirrhosis, red blood cell count can reflect the degree of liver damage, which may contribute to an improved liver function prediction model for these patients.

Erythrocyte Count ; Hepatitis ; blood ; Humans ; Liver ; physiopathology ; Liver Cirrhosis ; blood ; Liver Neoplasms ; blood ; Retrospective Studies

Objective To investigate Shanghai rehabilitation resources and services, define the status and problems and provide suggestions for making Shanghai rehabilitation health care system planning. Methods Based on the "Structure-Process-Result" theoretical framework, the questionnaire survey and field investigation were conducted on medical institutions in term of the rehabilitation departments setting, manpower, beds, equipment, housing, income and expenditure, and referral services. Results There were 321 rehabilitation doctors, 860 rehabilitation therapists and 666 rehabilitation nurses, 2199 preparation beds and 2573 real beds in all kinds of rehabilitation medical institutions. The rates of carrying out rehabilitation services were 94.79% in general hospitals, 100.00% in rehabilitation hospitals, 75.56% in community health service centers, rehabilitation equipment rates were 50.79%, 71.15%, 17.77%, and 27.73 %, 30.00%, 13.21% of them provided outpatient rehabilitation services. Conclusion Shanghai tertiary rehabilitation medical services architecture has initially formed, however, there are still many problems in the rehabilitation function. The rehabilitation health care system planning should focus on rehabilitation services capacity, rehabilitation staff team, rehabilitation resources and services referrals.

Objective To investigate the status of rehabilitation personnel in Shanghai. Methods Shanghai medical institutions were investigated through self-questionnaire including rehabilitation personnel quantity, basic characteristics of sociology and training from 2011 to 2013. Results There are 2262 rehabilitation personnel on duty in the medical institutions, with 321 rehabilitation doctors, 860 rehabilitation therapists and 666 rehabilitation nurses, 415 people without identity; female rehabilitation doctors, female rehabilitation therapists and female rehabilitation nurses account for 48.91%, 54.77%, 98.80% respectively; 25-34 years old group accounts for 44.24%, 38.84% and 39.79% respectively; working less than 5 years accounts for 30.84%, 65.00% and 60.81% respectively. Rehabilitation doctors with bachelor degree and clinical profession account for 56.70% and 75.07% respectively; rehabilitation therapists with college degree and rehabilitation profession account for 48.37% and 89.19% respectively; rehabilitation nurses with college degree and nursing profession account for 52.25% and 99.55% respectively; rehabilitation physicians, therapists and rehabilitation nurses who didn't accept the professional training of rehabilitation account for 4.36%, 4.07% and 28.68% respectively. Conclusion Shanghai rehabilitation personnel are deficient and some staff has not yet been identified, rehabilitation personnel structure and functional reeducation also need to be reinforced.