Objective To investigate the missing rate of polypus with colonoscopy and correlation factors for missed diagnosis.Methods Data with colorectal polyps collected a second colonoscopy within 180 days after polyps were detected and removed on the initial colonoscopy in 186 patients between July 2009 and June 2013.The following factors were statistically analyzed,including lesionrelated factors (the lesion size,location,shape,number,and pathology),and non-lesion-related factors (intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).Results Polypus missed diagnosis was found in 57 patients out of 186 recruited subjects (30.64％).A total of 76 polypus were missed out of 343 (22.16％) polypus detected by repeated colonoscopy.Flat small polyps were easily missed diagnosis (P ＜ 0.01).Polyps located at sigmoid,cecum and ascending colon,hepatic flexure,and splenic flexure were easily missed diagnosis (P ＜0.05).The rate of missed diagnosis was significantly increased in the condition of the low intestinal cleanliness,short colonoscopy post-set time,non-intravenous anesthesia,and beginner colonoscopy doctors (P ＜ 0.01).Conclusions A markedly missing rate of polyp existed on colonoscopy,and was closely related to the lesion-related factors (the lesion size,location,shape,number,and pathology) and the non-lesion-related factors (the intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).

Objective To explore the effect of combined use of antiplatelet drugs on late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.Methods Data with late-onset bleeding after high frequency electric resection of the colon polyps on colonoscopy were collected from 64 elderly patients using antiplatelet drugs from January 2010 to December 2013.Those 64 elderly patiets using antiplatelet drugs were divided into aspirin,clopidogrel,and aspirin + clopidogrel groups.The clinical situation,blood-coagulation time,bleeding-occurrence time,emergency colonoscopy hemostatic rate of demand,and hemostatic time in hospital were analyzed.Results No statistically significant differences were found in the blood-coagulation time,bleeding-occurrence time,and hemostatic time in hospital among aspirin,clopidogrel,and aspirin + clopidogrel groups.However,the clinical situation,and emergency colonoscopy hemostatic rate of demand in aspirin + clopidogrel group were significantly more serious and higher than those of the aspirin or clopidogrel groups (P ＜ 0.01).Conclusions There are more serious clinical situation and higher emergency colonoscopy hemostatic demand in patients with combined use of antiplatelet drugs relative to the use of single antiplatelet drug.The clinicians should pay attention to the combined use of antiplatelet drugs for late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.

Objective To evaluate the safety of mesohepatectomy for centrally located large hepatic tumors.Methods The clinical data of 37 patients who underwent hepatectomy for centrally located large liver tumors in our hospital from October 2010 to August 2015 were retrospectively analyzed.During the operation,the left and right hemilivers were mobilized.Slings for the improved liver hanging maneuver and for selective hepatic vascular occlusion were placed.These slings were used when necessary in order to minimize occlusion and ischemia time to the residual liver,and to maximize the volume of functional liver remnant.Mesohepatectomy was carried out using a microwave hemostatic separator.The feasibility,its effects on preventing hemorrhage,the degree of liver damage and the postoperative complications were evaluated.Results The mean diameter of the neoplasms was (12.6 ± 7.2) cm.The vascular inflow occlusion time of the left and right hemilivers were (12.2 ±3.5) min and (18.5 ±7.1) min,respectively.The blood loss was (487 ± 352) ml.The amount of red blood cell transfusion was (2.7 ± 1.9) U.The operation time was (215 ± 72) min.TBIL,ALT and AST reached their peak levels on the 1 st day after operation and they were higher than before surgery (P ＜ 0.01).The levels were then significantly decreased on the 3rd day after operation.However,the TBIL (P ＜ 0.05),ALT (P ＜ 0.01) and AST (P ＜ 0.05) were higher than the preoperative level,and only returned to normal or were close to the preoperative value on the 7th day after operation (P ＞ 0.05).The initial increase in ALT was quick and then it slowed down,while the initial increase in AST was slow but it decreased quickly.Conclusions Mesohepatectomy for centrally located large hepatic tumors could safely be carried out using the liver hanging maneuver combined with selective hepatic vascular occlusion and a microwave hemostatic separator.This method has the advantages of causing less bleeding,liver damage and rapid recovery.

Correspondinga uthor:Wan Chun, Email:mdchunwan@163.com
[Absrt act] Obj ective To summarize the clinical experience with isolated complete resection of he-patic caudate lobe in 14 patients. Mte hods The clinical data of 14patients with isolated complete resection of hepatic caudate lobe carried out in our hospital from December 2007 to March 2015 were retrospectively analyzed .During the operation , selective hepatic vascular occlusion slings , and supra-and infra-hepatic in-ferior vena cava slings were placed after full mobilization of the liver .Isolated complete resection of the he-patic caudate lobe was performed through the left and /or the right , the anterior liver-splitting or the retro-grade approaches .Results The mean operation time was (227 ±64) min.The mean amount of blood loss was (530 ±325) ml.The mean vascular occlusion time was (19.5 ±18.6) min.The mean diameter of ne-oplasm was (15 4.±9 .2) cm. All the operations were successfully carried out .There were no massive hem-orrhage, bile leakage or perioperative death .Hydrothorax occurred in 3 patients and ascites in 2.The mean stay in hospital was (21 ±9) days.All the patients were cured and discharged home .Conclusion Isolated complete resection of hepatic caudate lobe was feasible in clinical practice .

Abstract: Objective　To analyze the drug sensitivity and the carrying of carbapenem resistant gene of Acinetobacter baumannii isolated from clinical patients and clinical objects, and analyze the homology of strains to provide support for the control of nosocomial infection. Methods　A total of 38 strains of Acinetobacter baumannii isolated from patients and clinical objects surface were collected from January 2019 to August 2020. The antimicrobial susceptibility was tested by the minimum inhibitory concentration method. In addition, the resistance related genes were detected by polymerase chain reaction method, and homology analysis was performed by enterobacterial repetitive Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR). Results All 34 strains of Acinetobacter baumannii isolated from Clinical patients and 4 strains isolated from clinical objects carried blaOXA-51 and imp resistance genes, neither of them carried blaVIM gene. 32 Acinetobacter baumannii carrying blaOXA-23 gene, 28 strains carrying blaTEM gene, 7 strains carrying blaOXA-58 gene. After cluster analysis, 38 Acinetobacter baumannii isolates were classified into 7 genotypes (expressed A, B, C, D, E, F, G), and cluster E and cluster G were the main clusters, containing 12 strains (12/38, 31.6%) and 18 strains (18/38, 47.4%), respectively, as the main prevalent clonal strains. Conclusions　Acinetobacter baumannii isolated from different sources have the significant differences in drug resistance and carry different resistance genes. There is no direct correlation between patients and environmental isolates of Acinetobacter baumannii belonging to different clonal strains. Also, there aren’t significant correlation between clinical patients infected with Acinetobacter baumannii.

Objective To understand the Helicobacter pylori ( Hp) infection eradication rate of standard tri-ple therapy in Guangdong Meizhou and the drug resistance situation for metronidazole ,clarithromycin ,amoxicillin and levofloxacin ,in order to look for the treatment countermeasures in Hp eradication failure .Methods 297 cases of Hp positive patients because of gastrointestinal symptoms to our hospital examined from April 2011 and March 2013,were randomly assigned into three standard triple therapy groups:A ( OCA ) group and B ( OCM ) group and C ( OCL ) group.The Hp eradication rate was analyzed .Patients with primary treatment failure were selected as group D (OBAL),proceed to (PPl+B+A+L)7 d therapy,the Hp eradication rate was analyzed .230 Hp strains were isola-ted and cultured from 297 cases received the first eradication therapy and 87 cases received again eradication therapy . The minimum inhibitory concentration (MIC) of metronidazole,clarithromycin,amoxicillin and levofloxacin were tested by E-test,in order to determine the resistance of these four antibiotics in clinical isolated Hp strains .Results With intention-to-treat(ITT) analysis,the Hp eradication rates of group A (OCA),group B(OCM) and group C(OCL) were 72.0%(72/100),63.0%(63/100) and 72.2%(70/97),respectively.With per-protocol(PP) analysis,the Hp eradication rates of group A (OCA),group B(OCM) and group C(OCL) were 72.7%(72/99),64.3%(63/98),73.7%(70/95),respectively.The eradication rate among three standard triple therapy groups had no obvi-ous difference (ITT:P=0.278,PP:P=0.288,P>0.05).With ITT analysis,the Hp eradication rate in the quadrup-le therapy group D(OBAL) was 92.0%(80/87).With per-protocol(PP) analysis,the Hp eradication rate in the quadruple therapy group D(OBAL) was 97.6%(80/82),which was higher than that of the three standard triple ther-apy groups(ITT:P=0.000,PP:P=0.000).In 230 clinical isolated Hp strains,the resistant rates of levofloxacin,amoxicillin,clarithromycin and metronidazole were 6.08%(14/230),6.52%(15/230),25.65%(59/230), 70.87%(163/230),respectively.Of those 37 strains were mixed resistance,the mixed resistant rate was 16.09%(37/230).The resistant rate of metronidazole was higher than levofloxacin , amoxicillin and clarithromycin ( P =0.000,P<0.01),the resistant rate of clarithromycin was higher than levofloxacin and amoxicillin (P=0.000),no statistically significant difference between amoxicillin and levofloxacin (P=0.848).Conclusion The Hp resistance is similar to the national average in Guangdong Meizhou ,the eradication rate of standard triple therapy is lower than 80%,contain bismuth agent of quadruple therapy is good rescue therapy .

No abstract available.
Chungcheongnam-do* ; Humans ; Infant* ; Sex Ratio*

No abstract available.
Female ; Labor, Induced* ; Pregnancy*

Objective To explore the predictive effect of depression and impulsivity on suicidal ideation in violent criminals.methods 423 violent criminals were assessed by Self-rating Idea of Suicide Scale(SIOSS),Patient Health Questionnaire (PHQ-9) and Barratt Impulsiveness Scale(BIS-11).Result sPeople with suicidal ideation accounted for 17.04% of the total number of violent criminals.The scores of the group with suicidal ideation (respectively (4.95±4.82),(56.79±8.68),(12.95±2.29),(19.03±3.91),(28.81±4.95)) were higher than those without suicidal ideation group (respectively (4.95±4.82),(56.79±8.68),(12.95±2.29),(19.03±3.91),(28.81±4.95)) in depression and every dimension of impulsivity(attentional impulsivity,motor impulsivity and non-planning impulsivity) (t=9.49,t=4.61,t=4.04,t=3.88,t=3.08) (all P<0.01).Positive correlation was observed between suicidal ideation,depression and impulsivity(r=0.156-0.628,P<0.01),while sleeping factor was not associated with non-planning impulsivity.According to the multi-factoral regression module,depression and nonplanning impulsivity scores had positive prediction on suicidal ideation(R2=0.419,SIOSS=-2.471+ 0.192× depression+ 0.149× nonplanning impulsivity).Conclusion There is a close relationship in suicidal ideation,depression and impulsivity,meanwhile depression and nonplanning impulsivity can predict the suicidal ideation.

No abstract available.
Diagnosis* ; Hemophilia A* ; Molecular Biology* ; Polymorphism, Restriction Fragment Length*