Objective To investigate the influencing factors of chronic brucellosis.Methods Nested case control method was used to study newly diagnosed patients (n =600) with brucellosis in a cohort study in 2012.Data of general characterstics,clinical presentation,treatment and prognosis of those patients were collected.These patients were followed up for one year,and the chronic patients as the case group (n =248) and the healed patients as a control group (n =260).By means of Logistic multivariate analysis,factors turned brucellosis into chronic were screened.Result The chronic brucellosis-related factors were:gender,veterinary or epidemic prevention staff,muscle and joint pain,fatigue symptoms,and substandard treatment (x2 =5.163,16.445,14.977,17.154,8.813,all P ＜ 0.05).Conclusion Gender (female),veterinary or epidemic prevention staff,muscle and joint pain,fatigue symptoms,and substandard treatment are probably the chronic brucellosis-related factors

Objective To assess the value of 18F-FDG PET/CT in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of Castleman's disease (CD).Methods Fourteen pathologically diagnosed CD patients (7 males,7 females; mean age:(45.64±14.30) years) were retrospectively reviewed.18F-FDG PET/CT was performed before chemotherapy in all patients and 4 of 14 patients were reexamined after the treatment.The study parameters included histopathological results,sites,number and highest SUVmax of the lesions.Mann-Whitney and Kruskal-Wallis tests were used for data analysis.Results Of all the 12 patients without histopathological transformation,one or more enlarged and metabolically active lymph nodes were found in each patient (SUVmax =3.94± 1.44,range:1.9-6.8),including 2 unicentric CD (UCD) and 10 multicentric CD (MCD).There was no statistically significant difference of SUVmam between UCD and MCD (4.55±3.18 vs 3.82±1.14; Z=0.22,P＞0.05).There was also no significant difference of SUVmax among different pathological types (hyaline-vascular CD (4/12):3.56±0.96,plasma cell CD (6/12):4.73±1.41,mixed CD (2/12):2.30±0.57; x2 =4.74,P＞0.05).For the 4 patients with follow-up PET/CT after chemotherapy,the lesion activity was normalized in 3 patients and clearly reduced in 1 patient.The SUVmax of 2 patients with histopathological transformation (10.85±2.05) was significantly higher than that without transformation (3.94± 1.44; Z=-2.19,P＜0.05).Conclusion 18F-FDG PET/CT may play an important role in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of CD.

Objective To investigate the echocardiographic determination of uremic patients with myocardial weight and in the evaluation of cardiac function in patients with uremia heart the significance of the damage.Methods 70 cases of uremic patients and 30 normal physical were examined by routine echocardiography,cardiac measurements through the menu of uremic patients with myocardial weight and heart function.The patient group and the normal control group were compared.Results 70 patients with uremic echocardiography resuits of the analysis showed,respectively,12.8%and 84.3%existence of left ventricular systolic dysfunction and left ventricular diastolic dysfunction.left ventricular mass in patients with significant increase are significantly higher than those in healthy control group(P＜0.01).Conclusion Uremic patients left ventricular diastolic dysfunction and left ventricular hypertrophy most of echocardiography is the detection of cardiac damage in patients with uremia practical,sensitive,non-invasive examination will be able to clinical diagnosis and treatment provide guidance in the clinical widely used.

Objective To study the clinical valne of color Doppler ultrasound for the diagnosis of primary ureteral carcinoma. Methods 15 patients with pathologically confirmed primary ureteral carcinoma by color Doppler ultrasound were retrospectively analyzed. Results 15 patients with lesions above the ureter and renal pelvis and varying degrees of expansion,water, of which 11 cases of solid mass within the probe and ureter. Color Doppler showed lesions could be detected, and dot, stripe and dendritic arterial blood flow signal, resistance index (RI) 0. 58 ～ 0. 67.Conclusion Color Doppler ultrasound screening of primary ureteral carcinoma has important diagnostic value, can increase the rate of preoperative diagnosis,and can provide reference for clinical staging.

Objective To explore the clinical application and value of percutaneous transhepatic gallbladder drainage (PTGD)under CT guide in high-risk emergency.Methods In all 57 old patients with high-risk acute cholecystitis in emergency,cuff-PTGD in 39 was performed and fractional step PTGD in 18 was also used.Results PTGD was successfully in all patients.After PTGD,except for 1 patient died of severe cardiac insufficiency,the abdominal pain and fever were alleviated during 72 hours,and the complications was not demonstrated.Conclusion As a safe,noninvasive and accurate method,CT-guided PTGD may relieve symptoms quickly,reduce the mortality and improve the treatment for some old patients with high risk acute cholecystitis.

Objective: To evaluate the diagnostic value of fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography ( PET/CT) in fever of unknown origin ( FUO) in a Chinese hospital .Methods:The records of 51 patients with FUO (32 men and 19 women;mean age 54 years with a range between 3 and 81 years) were analyzed retrospectively .All the patients were examined by 18 F-FDG PET/CT scan and the results were compared with the final diagnosis which was established by additional procedures including pathology , laboratory examination , and clinical follow-up for more than 3 months.The t test was used for statistical analysis .Results: A final diagnosis was established for 48 patients , including 32 patients with infectious diseases , 9 with malignancies , and 7 with non-infectious inflammatory diseases .By FDG PET scan alone , the rates of true positive , false positive , false negative, and true negative were 52.9%, 27.5%, 17.6%, and 2.0%, respectively.By FDG PET/CT scan, the rates of true positive, false positive, false negative, and true negative were 70.6%, 27.5%, 2.0%, and 0, respectively.18F-PET/CT had a sensitivity of 97.3%(36/37), specificity of 0 (0/14), and accuracy of 70.6%(36/51) in FUO, especially a high sensitivity and accuracy of 100%(9/9) in the diagnosis of malignant tumor .Moreover , the maximum standardized uptake value ( SUVmax ) in tumor was significant higher than that in infection (3.7 ±2.7 vs.7.7 ±3.5, P=0.001, t=3.6), which implied that SUVmax might be useful in differential diagnosis in FUO .Conclusion:FDG PET/CT is a valuable imaging tool for the identification and location of the potential lesion in FUO and is helpful for the etiological diagnosis , especially in the diagnosis of malignant lesions .

Objective To evaluate the usefulness of delayed parenchymal transit time (PTT) on 99TcmDTPA diuretic renography as a predictor for functional improvement after Anderson-Hynes dismembered pyeloplasty in patients with ureteropelvic junction obstruction (UPJO).Methods Forty-seven patients (37males,10 females,age (29.7± 10.8) years) with unilateral U PJO were retrospectively analyzed.All patients underwent 99Tcm-DTPA diuretic renography before and after the surgery.Patient age,sex,UPJO location,surgical methods,relative renal function (RRF) of the diseased kidney (uptake ratio of UPJO kidney to both kidneys),and PTT were recorded.Delayed PTT was defined as having one of the following criteria: (1) photopenic pelvis between the second and seventh frame; (2) relatively stable tracer distribution within the kidney between the second to ninth frame with nearly unchanged kidney shape and size; (3) ever increasing activity in the parenchyma; (4) slower clearance from the parenchyma into the pelvis since the second frame compared with the contralateral healthy kidney.The relationship between the above-mentioned factors and RRF improvement (RRFpvst-surgery,-RRFpre-sugery) was analyzed.Paired t test,Kruskal-Wallis and Mann-Whitney rank sum tests and Pearson correlation analysis were used.Results The average RRF of pre-and post-surgery was (40.70± 13.30) ％ and (44.96 ± 12.60) ％,respectively (t =4.19,P ＜ 0.01).RRF improvement between the delayed group (n=16) and normal timely PTT group (n=27) was significantly different: ((11.69±6.52) ％ vs (0.48±2.98) ％,Z=-5.13,P＜0.01).The assessment of delayed or normal PTT could not be determined in 4 patients.No statistically significant differences of RRF improvement were found between pre-surgery RRF ＜ 40％ and RRF ≥ 40％ groups,between left and right UPJO groups,between open surgery and laparoscope groups,between male and female patients (Z =-1.93 to 1.25,all P＞0.05).There was no significant correlation between RRF improvement and patient age (r =0.01,P＞0.05).Conclusion Delayed PTT on 99Tcm-DTPA diuretic renography might be the predictor for functional improvement post surgery in UPJO patients.

Objective To investigate the drug resistance and the distribution situation of the related drug resistant genes in Staphylococcus aureus (SA), and to provide a basis for the clinical rational use of antibiotics and the hospital control of infection. Methods A total of 135 strains of SA were collected from the Second Affiliated Hospital of Baotou Medical College during January to December 2017. BD Phoenix TM-100 automatic microorganism identification and drug sensitivity systems and K-B agar diffusion method were used to identify SA colony and analyze its drug susceptibility; the related drug resistant genes were detected by polymerase chain reaction (PCR). Results Among 135 strains of SA, 16 (11.9%) methicillin-resistant SA (MRSA) and 119 (88.1%) methicillin-sensitive SA (MSSA) were detected. In the 14 strains of MRSA, the resistance rates to ampicillin, penicillin and erythromycin were high (91.9%, 91.1% and 64.4%, respectively), and no vancomycin, teicoplanin and linezolid-resistant strains were found. Additionally, the resistance rates of MRSA to ciprofloxacin were significantly higher than that of MSSA [31.3% (5/16) vs. 5.0% (6/119), P < 0.05]. Among 135 strains of SA, the detection rates of mecA, aac(6')/aph(2"), erm(A), erm(B), erm(C), and tetM were 4.4% (6/135), 10.4% (14/135), 0.7% (1/135), 27.4% (37/135), 31.4% (46/135) and 0.7% (1/135), respectively. In MRSA, the detection rates of mecA [37.5% (6/16) vs. 0 (0/119)], aac(6')/aph(2") [31.3% (5/16) vs. 7.6% (9/119)], and ermB [31.3% (5/16) vs. 26.9% (32/119)] were significantly higher than those in MSSA. It is noteworthy that the detection rate of mecA in MRSA was only 37.5% (6/16). Conclusions The MRSA detection rate of our hospital was below the national average level. The detection rates of resistance genes mecA, aac(6')/aph(2") and ermB were higher, which may be an important cause of drug resistance. Moreover, the detection of MRSA by mecA alone may lead to missed diagnosis, that should be paid attention to.

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