Objective To observe the clinical effect of peroutaneous ethanol injection therapy (PEIT) of parathyroid gland guided by color ultrasound on dialysis patients with secondary hyperparathy-roidism. Methods Percutaneons ethanol injection therapy (PELT) was used for seven patients who suf-fered from secondary hyperparathyroidism, and systemic perioperative nursing care and relative health edu-cation were applied. Results All patients had obtained successful operation without any operative sud-denness or associated complications,Patients" serious scratching and bone ache was obviously relieved.Conclusions Treatment with PEIT and effective nursing to patients suffered from secondary hyper-parathyroidism can reduce the complications, and than improve the quality of live for patients.

Colorectal Neoplasms ; genetics ; DNA Mutational Analysis ; standards ; Humans ; Mutation ; Proto-Oncogene Proteins B-raf ; genetics ; ras Proteins ; genetics

OBJECTIVE: The purpose of the study was to observe the CT imaging features of the frontal recess regional. METHOD: Eighty-two patients were undergone spiral computed tomography (CT). Then multiplanar reconstruction images were made using standard triplanar reconstruction protocol on a computer workstation. RESULT: The prevalence of agger nasi cell was 87.8% (144/164). One hundred and forty-five (89%, 145/164) uncinate processes had one superior attachment for each uncinate process. The others had two superior attachments for each uncinate process. The uncinate process' single superior attachment of into the surrounding structures was identified to have the following distribution: 90/164 (54.9%): to the lamina papyracea, 50/164 (30.5%) to the middle turbinate, and 5/164 (3.0%) to the skull base. Of all the frontal cells were identified in 144 (87.8%) sides of frontal recesses, the prevalence of type I II, type III IV, were 30.5% and 9.8% respectively. CONCLUSION T Agger nasi cell and uncinate process play an important role in endoscopic frontal sinus surgery.
Adolescent ; Adult ; Aged ; Child ; Female ; Frontal Lobe ; diagnostic imaging ; Frontal Sinus ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Nasal Cavity ; diagnostic imaging ; Tomography, X-Ray Computed ; Turbinates ; diagnostic imaging ; Young Adult

The 2019 novel coronavirus (2019-nCoV) outbreak in Wuhan, Hubei Province, China in 2019 led to large numbers of peoplebeing infected and developing atypical pneumonia (coronavirus disease 2019, COVID-19). Typical imaging manifestations ofpatients infected with 2019-nCoV has been reported, but we encountered an atypical radiological manifestation on baselinecomputed tomography (CT) images in three patients from Wuhan, China infected with the 2019-nCoV. Surprisingly, the onlysimilar CT finding was a solitary sub-centimeter ground-glass nodule adjacent to bronchovascular bundles, which could beeasily overlooked. In addition, the follow-up images in these patients showed how COVID-19 pneumonia evolved from thesesmall nodules. The radiologic manifestation of the three cases will expand contemporary understanding of COVID-19.

Viral central nervous system infection (VCNSI), with high disability and mortality rates, is a serious threat for the health of children. Given the low pathogen load in cerebrospinal fluid and limitations of conventional virus detection technology, the early pathogenic diagnosis methods are less than ideal. With the development of multiplex polymerase chain reaction (PCR), digital PCR, point-of-care testing detection of nucleic acid, and metagenome high-throughput sequencing, the clinical use of viral diagnostic technologies has become more prevalent. In this comment, the current status and future directions of laboratory diagnosis of VCNSI in children are discussed.

Objective:To assess the bacterial profiles and antimicrobial susceptibility patterns in uropathogens, and help to inform the empiric treatment decisions for urinary tract infection in outpatient settings.Methods:A single institutional retrospective analysis was performed on positive urine cultures from outpatient settings between January 1998 and December 2018. To analyze changes over time, trends analysis were undertaken on bacterial profiles, antimicrobial susceptibility and resistance.Results:A total of 1.172 pathogenic bacteria were isolated after exclusion of duplicate strains originated from the same patient, including 991(84.6%) Gram-negative bacterial strains and 181(15.4%) Gram-positive strains. The most common Gram-negative uropathogens were Escherichia coli (60.8%) and Klebsiella pneumonia (8.1%). Enterococcus faecalis (4.6%) was the predominant Gram-positive strain. The detection rate of Escherichia coli increased significantly, from 50.8% to 63.2% ( χ2=7.978, P=0.046), and no significant difference was observed in the distribution of major uropathogenic bacteria over the 20 years (all P>0.05). The proportion of extended-spectrum β-lactamase (ESBLs) producing strains increased significantly across the 20 years ( P<0.05). The resistance rates of Escherichia coli to amoxicillin and clavulanate potassium, aztreonam, ceftazidime, ciprofloxacin and sulbactam + cefoperazone increased significantly (all P<0.05). All the isolates sustained high susceptibility to tazobactam + piperacillin, amikacin, imipenem and nitrofurantoin (95.0%, 95.7%, 97.9% and 91.1%). Similar to those of Escherichia coli, Klebsiella pneumoniae remained a high and stable sensitivity to tazobactam+piperacillin, amikacin and imipenem during the 20 years (79.1%, 88.0% and 80.3%). However, the proportion of ESBLs producing strains increased significantly ( P<0.05). Among Gram-positive bacteria isolates, the sensitivity rates of Enterococcus faecalis to ampicillin, nitrofurantoin and penicillin G were 100.0%. No vancomycin resistant strain was detected in Gram-positive bacteria. Conclusions:From 1998 to 2018, Escherichia coli and Klebsiella pneumoniae are the most common Gram-negative bacteria uropathogens obtained in outpatient settings. Significant increases of resistance to some antimicrobial agents such as second- and third-generation cephalosporins and fluoroquinolones are observed during the 20 years and high susceptibilities to tazobactam+piperacillin, amikacin, imipenem and nitrofurantoin sustain over time. Local treatment strategies of urinary tract infections on outpatient basis should be made according to epidemiology of drug resistance and individual characteristics to control the spread and curb the prevalence of drug resistant.

OBJECTIVEDirectly excited the denervated orbicularis oculi muscle (OOM) by electric current on rabbits, to induce efficient eyelid closure, and seek the optimal sites for such excitation that can produce efficient eyelid closure with the minimal excitating current in the least channel.

METHODSBilateral peripheral facial paralysis model on 20 healthy NewZealand rabbits (40 sides) were prepared. Exciting current was designed for two-way rectangular pulse, 35 Hz frequency and 0.2ms pulse width. The current intensity could be adjusted between 0 and 2.5 mA. Middle of upper-orbit (A), outer orbital rim (B), and middle of lower-orbit (C) sites were located around the OOM. Each site underwent parallel muscle fiber excitation by 2.5 and 5 mm distance dual-electrode respectively, additional dual-electrodes were also placed in A- B and A- C positions. All resulted in a total of 8 different exciting methods, and were labeled A2.5, A5.0, B2.5, B5.0, C2.5, C5.0, AB and AC. Then the current was adjusted to achieve efficient eyelid closure. The minimal current intensity needed was regarded as threshold value.

RESULTSAll efficient eyelid closure occurrence rates of 8 methods were compared with combined χ(2) test and showed significant difference. A crossed χ(2) test showed the rates of C2.5, C5.0, and AC was significant lower than the highest methods. Except 3 methods above, the mean threshold values of remain 5 methods were compared with ANOVA test and showed significant difference. Further Fisher's LSD test showed B2.5 had the lowest mean value, was significant lower than A2.5 and AB, P < 0.001, and had no significant difference with A5.0 and B5.0, P > 0.05. A5.0's mean value was significant lower than A2.5's, P < 0.05.

METHODSB2.5, B5.0 and A5.0 were more likely to achieve a perfect closure.

CONCLUSIONSMiddle of supraorbital margin (A) and outer orbital rim (B) are the ideal sites for electric excitation. Exciting the two sites can sufficiently induce the contraction of denervated OOM, leading to high efficient eyelid closure occurrence rates, more perfect closure meanwhile with lower threshold current value, which are priority options.

Animals ; Electric Stimulation ; Electrodes ; Eyelids ; physiology ; Facial Muscles ; physiology ; Facial Paralysis ; Orbit ; Rabbits

OBJECTIVETo investigate mutations frequencies of KRAS,NRAS and BRAF genes in colorectal carcinoma.

METHODSTissue specimens from 200 colorectal cancer patients at diagnosis were collected and subject to KRAS,NRAS and BRAF mutation analyses by PCR-based direct DNA sequencing targeting exons 2, 3 and 4 of KRAS gene, exons 2, 3 and 4 of NRAS gene and exon 15 of BRAF gene.

RESULTSActivating mutations were detected in KRAS (44%, 88/200), NRAS (2%, 4/200) and BRAF (5%, 10/200) in this study cohort.Among KRAS mutations, 64.8% (57/88) occurred in codon 12 and 12.5% (11/88) occurred in codon 13. KRAS gene mutation in exon 3 mainly involved codons 59 and 61. KRAS gene mutation in exon 4 mainly involved codons 117 and 146.

CONCLUSIONSMutations at exon 2 of KRAS gene have the highest frequency in colorectal carcinoma. Expanding the detection sites of KRAS gene combined with NRAS and BRAF genes may help to identify patients who will most likely benefit from targeted therapies.

Base Sequence ; Codon ; Colorectal Neoplasms ; genetics ; DNA Mutational Analysis ; Exons ; Female ; Genes, ras ; Humans ; Mutation ; Proto-Oncogene Proteins ; Proto-Oncogene Proteins B-raf ; genetics ; Sequence Analysis, DNA