Objective To investigate the clinical application value of endotoxin and (1-3)-β-D glucan detection in the patients with acute pancreatitis(AP).Methods The MB-80 microbiology rapid dynamic detection system was applied to detect the concentration of plasma LPS and (1-3)-β-D glucan in the patients with AP.Then the results were analyzed.Results Among 184 cases of AP complicating peripancreatic abscess and bilateral lung infection,endotoxin G-lipopolysaccharides positive was in 23 cases,the average value was 394.07 pg/mL,the positive rate was 10.87%,and 15 cases of Gram-negative bacterial infection were verified by the microorganism culture.Among 175 cases of AP complicating peripancreatic abscess and bilateral lung infection,67 cases were(1-3)-β-D glucan positive,the average value was 93.22 pg/mL,the positive rate was 38.29%,which were with the positive rate of serum(1-3)-β-D glucan in the non-AP group,the difference was statistically significant(P<0.05),the microorganism culture or smear verified that 22 cases were fungal infection.Conclusion Plasma endotoxin and (1-3)-β-D glucan detection provides the laboratory biological indicator and is conducive to the assessment of AP infection severity and clinical medication.

Objective To study the detection rate of contrast-enhanced ultrasound (CEUS) with different perfusion methods on rabbit VX2 small hepatocellular carcinoma less than 10.0 mm. Methods VX2 tumor cells were inoculated into the subcutaneous tissue of New Zealand rabbit′s thigh. Then the plant tumor were cut into small blocks under sterile conditions and transplanted into hepatic parenchyma in 30 New Zealand rabbits. The contrast media was injected through peripheral vein by single and double perfusion methods. The detection rate of two methods were compared. Results There were 41 hepatocellular carcinoma lesions in the 30 rabbits. There were 15 lesions with size between 3.0 mm and 5.0 mm, and 26 lesions between 5.0 mm and 10.0 mm in diameter. On CEUS, the VX2 tumor presented fast-in and fast-out pattern. In arterial phase, the lesion was enhanced rapidly. In portal venous phase, contrast began to wash out from the carcinoma. In delay phase, the enhancement of lesion was signiifcantly lower than the surrounding normal liver parenchyma. A total of 32 lesions were detected by single perfusion method, including 7 lesions ranging 3.0-5.0 mm and 25 lesions ranging 5.0-10.0 mm. A total of 39 lesions were detected by double perfusion method, including 13 lesions ranging 3.0-5.0 mm and 26 lesions ranging 5.0-10.0 mm. The detection rate of micro-hepatocellular carcinoma by single and double perfusion method was 78% and 95% respectively. The difference was statistically signiifcant (χ2=5.150, P=0.023). The detection rate of 3.0-5.0 mm lesions by single and double perfusion method was 47%and 87%, respectively. The difference was statistically signiifcant ( χ2=5.400, P=0.025). The detection rate of 5.0-10.0 mm lesions by single and double perfusion method was 96% and 100%, respectively. There was no statistically signiifcant difference (χ2=1.020, P=0.500). Conclusion The double perfusion method greatly promotes the detection of micro hepatocellular carcinoma, especially for the lesions less than 5.0 mm in diameter.

OBJECTIVETo observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week. In the control group, midodrine tablets were prescribed orally,three times a day. All the treatment was given for 9 weeks. The clinical effects of the two groups were observed, and the levels of luteinizing hormone(LH), testosterone(Tes) and estra4 diol(E2) were compared between the two groups.

RESULTSThe total effective rate of the observation group was, 89. 47%(17/19), which was better than 47.06% (8/17) of the control group(P<0. 05). The LH and Tes were obviously increased and E2 was decreased compared with those before treatment in the observation group(all P< 0. 01). Tes was raised(P<0. 05) and E2 was apparently declined in the control group(P<0. 01). After treatment, the differences of serum LH and Tes were statistically significant between the two groups(both P<0. 01).

CONCLUSIONNeedle-pricking therapy has advantages for functional retrograde ejaculation probably in that stimulating lumbosacral nerves can strengthen the function of pelvic floor muscles and urethral expansion muscle and regulate sexual gland axis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Ejaculation ; Humans ; Male ; Middle Aged ; Needles ; Sexual Dysfunction, Physiological ; physiopathology ; therapy ; Treatment Outcome

Objective To study the application value of G-lipopolysaccharides(G-LPS) detection in patients with traumatic brain injury(TBI).Methods From Jan.2013 to Jun.2014,plasma G-LPS of TBI-patients and non-patients in this hospital were detected by using MB-80 microbiology analyzer and compared.Results of pathogenic microbiological detection of G-LPS positive TBI patients were analyzed,and G-LPS levels,detected before and after treatment,were also analyzed.Results G-LPS positive rate of TBI patients(33.33%) was higher than the 13.34% of non-TBI patients(P<0.05).After treatment,G-LPS level in G-LPS positive TBI patients significantly decreased(P<0.05).The common pathogenic bacteria,causing infection in TBI patients,included Acinetobacter bauman,Klebsiella pneumoniae and Escherichia coli,and the most common infection diseases included respiratory tract infections and urinary tract infections.Conclusion G-LPS detection could be used for the early detection of secondary infection in TIB patients,with significance for guiding clinical treatment.

Objective: To investigate the epidemiological characteristics of 45 norovirus clusters in Baoshan District, Shanghai Municipality from 2019 to 2021, so as to provide the evidence for improving the management of norovirus clusters. Methods: The epidemiological characteristics and laboratory testing of 45 norovirus clusters were collected in Baoshan District from 2019 to 2021, and the temporal distribution, population distribution, distribution of places of norovirus clusters, clinical manifestations, laboratory testing results, origin of norovirus infection and transmission routes of norovirus clusters were analyzed using a descriptive epidemiological method. Results: A total of 45 norovirus clusters involving 29 379 individuals were reported in Baoshan District from 2019 to 2021, and 435 cases with norovirus infections were identified, with an average attack rate of 1.48%. Norovirus infection most often occurred from November to April of the following year, and the infection predominantly occurred among students (408 cases, 93.79%). There were 25 norovirus clusters in kindergartens (55.56%), 18 clusters in primary and middle schools (40.00%), one cluster in a social care facility and one cluster in a geriatric ward. Vomiting was the predominant clinical symptom (416 cases, 95.63%). The positive rate of norovirus was 37.35% in 597 samples. There were 40 norovirus clusters caused by the norovirus GⅡ genotype (88.89%), and the median duration of the norovirus cluster was 6 days (interquartile range, 1 day). In addition, 82.22% of the norovirus clusters reported to centers for disease control and prevention within 1 day,and 88.89% of the clusters were transmitted through human to human transmission or vomitus of cases. Conclusion The norovirus clusters predominantly occur in winter/spring and among students in Baoshan District from 2019 to 2021. Kindergartens and primary and middle schools are main places of norovirus infections, and the norovirus GⅡ genotype is the main type of pathogens. Human-to-human transmission and exposure to patients' vomitus are the main routes of transmission.

Objective To explore the clinical application value and feasibility of contrast-enhanced ultrasonography (CEUS) in rapid diagnosis for bleeding of hepatocellular carcinoma. Methods From January 2009 to December 2012, 58 patients from the 302nd Hospital of the People′s Liberation Army underwent CEUS and conventional ultrasound, who were suspicioused primary bleeding of liver cancer or secondary bleeding of liver cancer after percutaneous radiofrequency ablation (RFA). The change of effusion volume in front of liver and in abdominal cavity, the perfusion time, range and characteristics of contrast agent, tumor vessel and the characteristic manifestation of active bleeding within the tumor and subcapsular were evaluated. Theχ2 test was used to compare the show rates of lesion boundary and the bleeding point by conventional ultrasound and CEUS. The t test was used to compare the change of effusion in front of liver and in abdominal cavity from 0 min to 30 min after bleeding were diagnosis by CEUS. Results For 58 cases of suspicious rupture and bleeding of liver cancer, 34 cases were conifrmed by clinical and imaging ifndings. The bleeding points were detected by conventional ultrasound in 5 cases. The bleeding points in 30 cases (including 4 cases of rapid bleeding, 7 cases of medium bleeding and 19 cases of slow bleeding) were detected by CEUS. The detection rate of lesion boundary, tumor vessel and bleeding point of CEUS were higher than those of conventional ultrasound, and the differences were statistically significant (χ2=10.350, P=0.001; χ2=4.300, P=0.034;χ2=36.790, P=0.0007). CEUS showed that contrast agent continuously concentrated at the bleeding point of lesions, and different degrees of bleeding were shown as′jet-like′,′linear′or′intermittent′spillover. The volume of effusion in front of the liver and in abdominal cavity at 30 min was more than those at 0 min after bleeding were diagnosis by CEUS, and the differences were statistically significant (the volume of effusion in abdominal cavity:t=-3.467, P=0.026;t=-12.895, P=0.000;t=-3.055, P=0.007;the volume of effusion in front of the liver:t=-8.110, P=0.001;t=-5.642, P=0.002;t=-5.981, P=0.000). Conclusions CEUS can show direct signs of rupture and bleeding of liver cancer, and the degree of bleeding can be evaluated according to the extravasation characteristics of contrast medium and the changes of lfuid volume. Therefore, CEUS can provid an objective basis for rapid diagnosis of ruptured hepatocellular carcinoma in the emergency scene and bedside.

Objective: To investigate the epidemiological characteristics of cluster vomiting diarrhea outbreaks caused by Sapovirus infection in Baoshan District, Shanghai, and to provide reference for the standardized management of cluster vomiting diarrhea events in schools. Methods: The cluster of vomiting and diarrhea outbreaks in Baoshan District from 2017 to 2019 were collected, and the basic information and scene of each cluster were summarized. Sample results were collected and descriptive epidemiological methods were used to analyze the epidemiological characteristics of the outbreak. Results: From 2017 to 2019, a total of 100 cluster vomiting and diarrhea events were reported in Baoshan District, including 9 cases caused by Sapovirus, 120 cases of cluster vomiting diarrhea caused by Sapovirus, with an average incidence rate of 2.37%, including 39 laboratory confirmed cases, the epidemic epidemic time was mainly concentrated in September to November, the places were distributed in 4 primary schools and 5 kindergartens, the main clinical manifestations were vomiting (112/120, 93.33%), abdominal pain (27/120, 22.50%), diarrhea (26/120, 21.67%), compared with Norovirus events, the positive rate, vomiting and fever ratios of Zarovirus were lower than those of Norovirus( χ 2=8.32, 4.52, 14.20, P <0.05). Conclusion In school cluster vomiting and diarrhea events, the positive detection rate of Sapovirus is second enteric vinus behind Norovirus, and it s recommended to formulate a prevention and control plan for Sapovirus infection diarrhea to provide a basis for the on site treatment of school cluster vomiting diarrhea events.

Objective To study the effect of interferon-gamma release assays (IGRAs) adenosine deaminase activity test (ADA) and tuberculosis antibody test (TB-ab) in diagnosis of tuberculous pleurisy.Materials Sixty-three patients with pleurisy were tested for IGRAs,ADA and tuberculosis antibody.Samples of blood were tested.IGRAs,ADA and tuberculosis antibody were diagnosed according to manufacturer' s instructions.Results Either of the method could detect several patients with tuberculous pleurisy.Tuberculosis antibody showed lowest sensitivity and specificity.In our experiments,ADA test only detected 58.14％ of patients,although specificity can be high.We detected highest percentage of tuberculous pleurisy (79.07％) in blood IGRAs,with a specificity of 70％.Conclusion Blood IGRAs are more effective than blood ADA and tuberculosis antibody test,and it is recommend that IGRAs should be used in diagnosis of tuberculous pleurisy.

Objective: To investigate the effect of single antiepileptic drugs(AEDs) and combination therapy on the effect of seizure after stroke, prognosis and recurrent seizures. Methods: From November 2013 to December 2017, 280 patients with epilepsy and epilepsy that had been included in the epilepsy course and AEDs course for>6 months in Shaoxing Central Hospital were divided into early-onset epilepsy group and late-onset epilepsy group according to the patients' condition, with 140 cases in each group.According to different AEDs treatment regimens, they were further divided into monotherapy group(valproate) and combination therapy group(valproate, oxcarbazepine combined with levetiracetam). Results: The proportion of monotherapy in the early-onset epilepsy group was significantly higher than that of the late-onset epilepsy group, and the proportion of the late-onset epilepsy group was significantly higher than that of the early-onset epilepsy group(χ²=22.857, P<0.0001). The incidence and effectiveness of epilepsy patients after single-agent and combination therapy in the early-onset epilepsy group had statistically significant differences[onset rate: 40.0%(36/90) vs.16.0%(8/50), χ²=8.591, P=0.003; effective rate: 88.9%(80/90) vs.100.0%(50/50), χ²=5.983, P=0.014]. The incidence and effectiveness of single-agent and combination therapy in the late-onset epilepsy group had statistically significant differences [seizure rate: 40.0%(20/50) vs.82.2%(74/90), χ²=25.974, P=0.000; effective rate: 64.0%(32/50) vs.87.8%(79/90), χ²=11.065, P=0.000]. Conclusion The time of post-stroke epilepsy is not related with the site, type and risk factors of stroke; early epilepsy usually manifested partial seizures and had better curative effect of AEDs, and late epilepsy usually manifested overall tonic clonic seizure; there were no obvious difference in curative effect and recurrence rate of early and late epilepsy on single and combined AEDs treatment.

Humans ; Consensus ; Pancreatic Neoplasms/therapy* ; Neuroendocrine Tumors/therapy*