The association of plasma tissue type plasmingogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) with carotid atherosclerosis in patients with type 2 diabetes was explored.The subjects with type 2 diabetes (n =91) and control subjects (n =30) were enrolled for this study.According to carotid artery intima media thickness in Color Doppler Ultrasonography,the subjects with type 2 diabetes were divided into four groups:normal carotid group(group 1,n =25),lining thickening group (group 2,n =30),stable plaques group (group 3,n =23),carotid stenosis group(group 4,n =13).Plasma t-PA and PAI-1 levels were measured by ELISA.Compared with the control group,there was no significant change in the levels of plasma t-PA and PAI-1 in group 1 (P＞0.05),plasma t-PA activity was decreased significantly(P＜0.05) and PAI-1 activity increased obviously (P＜0.05) in group 2,group 3,and group 4.Carotid atherosclerosis degree was negatively correlated with t-PA(r=-0.723,P＜0.01) and positively correlated with PAI-1 (r=0.851,P＜0.01).The results suggested that the abnormal fibrinolysis function may take part in the development of atherosclerosis of carotid arteries in patients with type 2 diabetes.

Objective To investigate the role of transoralsonography guiding fine?needle aspiration biopsy in the diagnosis of retropharyngeal or parapharyngeal masses identified on the CT, MRI or PET?CT images of treated patients with malignant carcinoma. Methods From 2002 to 2013,this study recruited fifty?five patients with a history of cancer, of which 50 were treated with radiation treatment, including 46 nasopharyngeal carcinoma, 3 esophagus squamous cell carcinoma and1 lung apex carcinoma. There were 4 patients with a history of 1 thyroid papillary carcinoma, 1 buccal mucosa squamous cell carcinoma,1 glottis squamous cell carcinoma and 1 sigmoid colon adenocarcinoma treated with surgery. The rest one patient with nasal olfactory neuroblastoma was treated by postoperative radiation. The enlarged retropharyngeal lymph nodes in 44 cases and parapharyngeal masses in 10 cases were identified on CT or MRI imges. The enlarged retropharyngeal lymph node in the rest case was identified on PET?CT. With transoral ultrasound examination, all lesions were with hypo?intensity echo. Cystic areas were noted on occasion. Biopsy was performed in all cases. Results After cytology examination, carcinoma cells were detected in 37 retropharyngeal lymph nodes, with a detection rate of 82% (37/ 45). In the 10 parapharyngeal masses, carcinoma cells were detected in 3 lesions, with a detection rate of 30%. Conclusions Transor alsonography guiding fine?needle aspiration biopsy can be useful in the cytopathology diagnosis of retropharyngeal or parapharyngeal masses identified on the CT, MRI or PET?CT images of treated patients with malignant carcinoma,which facilitates, early diagnosis and treatment for patients.

Objective:To investigate status quo of social support and social function in homeless schizophrenics.Methods:A total of 468 schizophrenics who received treatment in Hangzhou Seventh People's Hospital from January 2018 to December 2019 were included in this study. They were divided into homeless group ( n = 310) and non-homeless group ( n = 158) according to whether they had homeless behaviors. The basic information of admitted patients, level of social support and disease severity were surveyed among admitted patients using self-made questionnaire regarding basic information of admitted patients, Social Support Rating Scale, and Brief Psychiatric Rating Scale. Results:The numbers of schizophrenics in the aspects including male gender, rural household registration, non-local residents, no occupation, unmarried status, low level education, and age at 30-50 years in the homeless group were significantly higher than those in the non-homeless group ( χ2 = 3.58, 20.14, 18.69, 46.29, 33.16, 24.38, 29.75, all P < 0.05). The score for each SSRS domain and total score in the homeless group were significantly lower than those in the non-homeless group [(15.35 ± 5.42) points, (4.34 ± 2.78) points, (6.48 ± 1.89) points, (26.23 ± 7.35) points; (18.99 ± 3.78) points, (6.35 ± 3.23) points, (7.82 ± 2.01) points, (32.59 ± 7.02) points, t = 6.34, 10.52, 12.83, 14.68, all P < 0.001]. The score for each BPRS domain and total score in the homeless group were significantly higher than those in the non-homeless group [(19.35 ± 5.85) points, (22.58 ± 2.73) points, (18.74 ± 2.46) points, (18.48 ± 0.25) points, (16.38 ± 3.12) points, (79.43 ± 3.64) points; (12.92 ± 4.23) points, (16.24 ± 3.66) points, (16.97 ± 3.77) points, (10.58 ± 3.34) points, (6.36 ± 4.23) points, (62.72 ± 2.57) points, t = 9.92, 7.02, 6.33, 10.35, 15.74, 28.46, all P < 0.001]. Conclusion:The poor individual condition and low level of social support in patients with schizophrenia are important factors that cause homelessness.

Objective:To evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) in tuberculous meningitis (TBM).Methods:From August 1, 2020 to August 31, 2022, 99 patients with suspected TBM admitted to the Tuberculosis Diagnosis and Treatment Center, Hangzhou Chest Hospital, Zhejiang University School of Medicine were enrolled. The cerebrospinal fluid (CSF) was tested for mNGS, GeneXpert Mycobacterium tuberculosis/rifampin (GeneXpert MTB/RIF) and mycobacterium culture. The sensitivity, specificity, positive predictive value, negative predictive value, agreement rate, Kappa value of the diagnostic efficacy of the three test methods were compared.The receiver-operating characteristic (ROC) curve of the diagnostic efficacy of mNGS was drawn. Chi-square test and rank sum test were used for statistical analysis. Results:Among the 99 suspected patients with TBM, 67 were diagnosed with TBM and 32 were non-TBM. Based on the results of 67 cases clinically diagnosed with TBM, the sensitivity, specificity, positive predictive value, negative predictive value, agreement rate and Kappa value of mNGS for the diagnosis of TBM were 82.1%, 100.0%, 100.0%, 72.7%, 87.9% and 0.748, respectively. The sensitivity of mNGS was higher than that of GeneXpert MTB/RIF (50.7%) and mycobacterium culture (28.4%). The differences were statistically significant ( χ2=12.61 and 32.42, respectively, both P<0.01). The detection time of mNGS was 1.0 (1.0, 2.0) day, which was shorter than 42.0 (42.0, 42.0) days of mycobacterium culture with statistical significance ( Z=10.80, P<0.001). ROC curve analysis showed that mNGS had the best diagnostic efficacy when the number of Mycobacterium tuberculosis sequences in CSF was one. Conclusions:The sensitivity and specificity of mNGS in the diagnosis of TBM are high, and the detection time is shorter, which could be used in the early diagnosis of TBM.

OBJECTIVETo investigate the role of multiple diagnostic methods in the head and neck tumor.

METHODSOne hundred and ninety-six patients without definite pathological diagnosis referred from other hospitals were included in this retrospective study. All patients had a biopsy or fine needle aspiration (FNA) of the suspected region after detailed medical history enquiry, physical examination and imaging examination.

RESULTSAll patients had ultrasound-guided FNA except 4 patients who had direct FNA. One hundred and seventy-one patients (87.2%) were confirmed to have tumor cells by pathological diagnosis, among them, 31 patients by biopsy of primary region alone, 106 by FNA, and 34 by both. The positive rate of FNA was 71.4% (140/196) for the whole group, 71.1% (123/173), 66.7% (10/15) and 87.5% (7/8) for retropharyngeal lymph node subgroup, parapharyngeal space subgroup and oropharynx subgroup.

CONCLUSIONThe combined use of endoscope, MRI, and ultrasound-guided FNA is useful for the diagnosis of head and neck tumor.

Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; methods ; Child ; Endoscopy ; Female ; Head and Neck Neoplasms ; diagnosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Young Adult