Objective To explore the value of quantitative parameters of spectral CT imaging in the diagnosis of non-small cell lung cancer (NSCLC) with different pathological types. Methods One hundred and thirty-six patients with NSCLC proved by pathology underwent chest plain and enhanced CT scan with gemstone spectral imaging (GSI) mode by Discovery CT750 HD, including 57 cases of squamous cell carcinoma (SQCC) and 79 cases of adenocarcinoma (ADC). All the cases were divided into two groups of tumor diameter>2 cm (120 cases, including 50 cases of SQCC and 70 cases of ADC) and diameter≤2 cm (16 cases, including 7 cases of SQCC and 9 cases of ADC). The slope between 40 and 65 keV(K40-65 keV) of spectral attenuation curve, effective atomic number (Eff-Z) and calcium concentration in plain scan (PS) and K40-65 keV of spectral attenuation curve, iodine concentration and water concentration in arterial phase (AP) of SQCC and ADC in the two groups were measured and compared respectively. Furthermore, all cases were classified according to the trend of spectral attenuation curve in PS. These quantitative parameters satisfying normal distribution were compared by two independent samples t test, while those parameters not satisfying normal distribution were compared by rank sum test. ROC curves was drawn for these parameters with statistical difference and area under the curve (AUC) was used to measure the differential diagnostic performance of each parameter. Chi square test was used to compare the differences of the trend of spectral attenuation curve in PS between SQCC and ADC. Results In the group of diameter>2 cm: (1) Comparison of quantitative parameters of spectral CT in PS:K40-65 keV, Eff-Z and calcium concentration of ADC were 0.69 ± 0.56, 7.76±0.19, and (4.11±2.93) mg/cm3, respectively. The corresponding parameters of SQCC were 0.19± 0.23, 7.59 ± 0.14, and (1.25 ± 1.59) mg/cm3, respectively. These parameters of ADC were significantly higher than SQCC (Z=-7.000,-6.249, t=-6.884, P<0.01). (2) Comparison of quantitative parameters of spectral CT in AP:K40-65 keV, iodine concentration and water concentration of ADC were 2.61 ± 1.72, (1.24 ± 0.77) mg/cm3, and (1024.46 ± 14.06) mg/cm3, respectively. The corresponding parameters of SQCC were 2.00 ± 1.79, (0.94±0.86) mg/cm3, and (1027.77±9.47) mg/cm3, respectively. The difference between ADC and SQCC was statistically significant (Z=-3.082,-2.946,-3.045, P<0.01). (3) ROC curve analysis showed that these quantitative parameters in PS were helpful in differentiating SQCC and ADC, especially K40-65 keV of spectral attenuation curve in PS. The AUC for it was 0.876. The sensitivity and specificity were 91.4%and 80.0%, respectively. (4)According to the trend of spectrum attenuation curve in PS, type Ⅰ was more common in SQCC, while typeⅡwas more common in ADC (χ2=54.208, P<0.01). In the group of diameter≤2 cm:There was no significant difference in all quantitative parameters between ADC and SQCC (P>0.05). The trend of spectrum attenuation curve in PS of all cases showed type Ⅱ. Conclusions Lung ADC and SQCC have different quantitative parameters in spectral CT imaging. These quantitative parameters are valuable in classifying the pathological type of NSCLC with diameter more than 2 cm.

Objective:To explore the effects of trust-building in nebulized inhalation nursing for bronchopneumonia children.Methods:From January 2017 to February 2018, we selected 96 bronchopneumonia children with nebulized inhalation in the First People's Hospital of Shangqiu. All children were randomly divided into observation group and control group with the block randomization, 48 cases in each group. Children of two groups were all treated with the nebulized inhalation and routine nursing after admission. On the basis of this, observation group established trust with the children and then implemented the nebulized inhalation. We compared the length of hospitalization, symptom relief time, hospitalization expense as well as treatment compliance of children between two groups.Results:The length of hospitalization, symptom relief time, hospitalization expense of children, and the number of crying in observation group were lower than those in control group, the score of subjective compliance of children in observation group was higher than that in control group, the differences were all statistical differences ( P<0.05) . The pulmonary function indexes in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05) . Conclusions:Implementation of trust-building in nebulized inhalation nursing for bronchopneumonia children can reduce the length of hospitalization and symptom relief time, and improve the lung function as well as treatment compliance of children which is worthy of popularization.

OBJECTIVETo identify pathogenic mutation of the TSC1 and TSC2 genes in a patient with tuberous sclerosis.

METHODSPeripheral venous blood samples and clinical data of a pregnant woman with tuberous sclerosis and 4 family members (parents, uncle and husband) were collected. Genomic DNA was extracted. All coding exons of the TSC1 and TSC2 genes and their flanking intronic sequences were amplified by polymerase chain reaction and subjected to direct sequencing.

RESULTSThe patient has presented facial angiofibroma and prefrons fibrous plaque for 20 years, and lumbar connective tissue nevus for 10 years. She also had mental retardation but no epilepsy. A novel frame-shift mutation c.4258-4261delTCAG was detected in exon 34 of the TSC2 gene, which had led to a premature stop codon TAG after the 55th amino acids. The same mutation was not found in the unaffected family members and 100 unrelated healthy controls.

CONCLUSIONThe novel frame-shifting mutation c.4258-4261delTCAG (p.Ser1420GlyfsX55) in the TSC2 gene may be responsible for the disease in the patient.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; DNA Mutational Analysis ; Female ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Pedigree ; Pregnancy ; Tuberous Sclerosis ; genetics ; Tumor Suppressor Proteins ; genetics ; Young Adult

Objective:To explore the effect of improved skin cleaning method combined with Incontinence-Associated Dermatitis Intervention Tool (IADIT) in the treatment of incontinence-associated dermatitis in critically ill patients.Methods:By convenience sampling, we selected the patients in Peking University Third Hospital as subjects. A total of 92 critically ill patients with fecal incontinence from March 2017 to February 2018 were set as the control group while 63 critically ill patients with fecal incontinence from March 2018 to February 2019 were set as the experimental group. Patients in the control group received routine care, and those in the experimental group received IADIT care. The incidence, curative effects and healing time of incontinence-associated dermatitis were compared between the two groups.Results:After the intervention, the incidence of incontinence-associated dermatitis in the experimental group was 30.16% (19/63) , which was lower than 44.57% (41/92) in the control group, and the difference between the two groups was statistically significant ( P<0.05) . The effective rate of incontinence-associated dermatitis in the experimental group was 94.74% (18/19) , which was higher than 65.86% (27/41) in the control group, and the difference between the two groups was statistically significant ( P<0.05) . The healing time of incontinence-associated dermatitis in the experimental group was (6.33±3.14) d, which was lower than (11.55±3.41) d in the control group, and the difference between the two groups was statistically significant ( P<0.01) . Conclusions:Compared with traditional empirical nursing methods, targeted interventions based on IADIT for critically ill patients with fecal incontinence can effectively reduce the incidence of incontinence-associated dermatitis, improve the cure rate of incontinence-associated dermatitis and shorten the healing time.

Objective:To investigate the features of chest computed tomography (CT) imaging and dynamic changes of severe corona virus disease 2019 (COVID-19).Methods:The clinical and CT data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.Results:The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and two cases presented with three lobes involved, one case with four lobes involved and 14 cases with five lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, three cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, three cases with lymphadenopathy with the short diameter of 1.0-1.2 cm.Among 16 patients who underwent repeated CT examination, the lesions of eight patients showed continuous improvement, and those of the other eight patients showed fluctuating changes.Conclusions:The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with five-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Pynamic monitoring chest CT is useful for the evaluation for the therapeutic effects.

Background::Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection.Methods::A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with coronavirus disease 2019 (COVID-19)-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2.Results::Among the infected groups, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs. 39.8% [92/231] vs. 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685–11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068–2.343), traditional systemic (adjusted OR = 1.887, 95% CI= 1.263–2.818), and nonsystemic treatment (adjusted OR= 1.602, 95% CI= 1.117–2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680–1.274, compared to no treatment), according to multivariable logistic regression analysis. Conclusions::A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension.