OBJECTIVES: To compare the application effect of microwave digestion - vacuum filtration - automated scanning electron microscopy (MD-VF-Auto SEM) method and plankton gene multiplex PCR system in the diagnosis of drowning. METHODS: Lung, liver and kidney tissue of 10 non-drowning cases and 50 drowning cases were prepared for further MD-VF-Auto SEM method analysis and plankton gene multiplex PCR system analysis. The positive detection rate of the two methods in each tissue was calculated. RESULTS: The positive rate of the MD-VF-Auto SEM method detecting diatoms in drowning cases was 100%, and few diatoms were detected in the liver and kidney tissues of 6 non-drowning cases. By using the plankton gene multiplex PCR system, the diatom positive rate of drowning cases was 84%, and all the non-drowning cases were negative. There were significant differences in the positive rate of the liver, kidney tissues between MD-VF-Auto SEM method and plankton gene multiplex PCR system (P<0.05), as well as the total positive rate of cases. However, no significant differences were found in the positive rates of lung tissues (P>0.05). CONCLUSIONS MD-VF-Auto SEM method is more sensitive than plankton gene multiplex PCR system in diatom test. But the plankton gene multiplex PCR system can also detect plankton other than diatoms. Combination of the two methods can provide a more reliable basis for the diagnosis of drowning.
Diatoms/genetics* ; Drowning/diagnosis* ; Humans ; Liver ; Lung ; Microscopy, Electron, Scanning ; Multiplex Polymerase Chain Reaction ; Plankton/genetics*

Objective To measure biomechanical parameters of the cornea after keratoconus and laser corneal refractive surgery by Scheimpflug noncontact tonometry (Corvis ST),and analyze the changes and differences in these parameters.Methods From April 2011 to November 2016,63 patients (96 eyes) with clinically diagnosed as keratoconus were selected as the keratoconus group,and 60 patients (120 eyes) underwent laser corneal refractive surgery between November 2016 to March 2017 were selected as postoperative cornea group,and totally 51 healthy person (102 eyes) who received physical examination during the same period were selected as healthy cornea group.Scheimpflug noncontact tonometry (Corvis ST) was performed to measure the length of appl 1,length of appl 2,velocity of appl 1,velocity of appl 2,maximum deformation amplitude,apex distance and radius of curvature in the three groups.Total comparison of biomechanical parameters was performed using ANOVA test among the three groups,while pairwise comparison was performed to analyze the difference of these parameters by SNK methods.Pearson or Spearman correlation analysis was applied to assess the differences in corneal morphological and biomechanical parameters.Results There was no significant difference in length of appl 1,length of appl 2 of the three groups (all P ＞ 0.05).And velocity of appl 1 in the keratoconus group was significantly higher than that of the healthy cornea group [(0.189 ± 0.230) m · s-1 vs.(0.151 ± 0.017)m · s-1] (P ＜ 0.05).As for velocity of appl 2,the keratoconus group was larger than the healthy cornea group,both which were larger than the postoperative cornea group,and the differences were significant (all P ＜ 0.05).And this was true of maximum deformation amplitude in the three groups,with the significant differences(all P ＜ 0.05).The apex distance in the keratoconus group was significantly longer than that in the healthy cornea group (P ＜ 0.05).The radius of curvature of the keratoconus group,postoperative cornea group and healthy cornea group were (5.696 ± 0.881) mm,(7.129 ± 0.681) mm and (7.012 ± 0.728) ram,respectively,which approached significant differences(all P ＜ 0.05).There was significant correlation between the anterior surface refractive power (Km) and apex distance and radius of curvature in the keratoconus group (r =-0.205,0.1 84;P =0.023,0.041),and maximum posterior surface elevation had a statistically significant correlation with velocity of appl 2,maximum deformation amplitude and radius of curvature (r =-0.579,-0.307,0.256,P =0.022,0.002,0.000).For the eyes in the postoperative cornea group,there were no significance correlation between the anterior surface refractive power (Km) and biomechanical properties (P ＞ 0.05),but significant correlation with length of appl 2 (r =-0.297,P =0.026).There were no significant correlation between maximum posterior surface elevation and biomechanical properties (P ＞ 0.05).Conclusion The corneal biomechanical parameters are decreased in eyes after keratoconus and laser corneal refractive surgery,and Corvis ST can become an auxiliary examination tool for earlier diagnosis of secondary keratoconus after corneal refractive surgery.

We assessed the role of diabetes mellitus (DM) on treatment effects in drug-susceptible initial pulmonary tuberculosis (PTB) patients. A prospective study was conducted in eight provinces of China from October 2008 to December 2010. We enrolled 1,313 confirmed drug-susceptible initial PTB patients, and all subjects received the treatment regimen (2H3R3E3Z3/4H3R3) as recommended by the national guidelines. Of the 1,313 PTB patients, 157 (11.9%) had DM; these patients had more sputum smear-positive rates at the end of the second month [adjusted odds ratios (aOR) 2.829, 95% confidence intervals (CI) 1.783-4.490], and higher treatment failure (aOR 2.120, 95% CI 1.565-3.477) and death rates (aOR 1.536, 95% CI 1.011-2.628). DM was a contributing factor for culture-positive rates at the end of the second month and treatment failure and death of PTB patients, thus playing an unfavorable role in treatment effects of PTB.
Antitubercular Agents ; therapeutic use ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; therapy ; Female ; Humans ; Male ; Mycobacterium tuberculosis ; drug effects ; Tuberculosis, Pulmonary ; complications ; drug therapy ; epidemiology ; microbiology

Objective To investigate the efficacy of phacoemulsification combined with intraocular lens implantation in the treatment of retinitis pigmentosa complicated with cataract.Methods A retrospective study was conducted in 52 patients (101 eyes) who admitted in Leshan People's Hospital from January 2012 to December 2016 after diagnosed with primary retinitis pigmentosa combined with cataract and underwent phacoemulsification combined with intraocular lens implantation,and then the clinical data were retrospectively analyzed.All patients were examined for the best corrected visual acuity (BCVA),intraocular pressure,slit lamp anterior segment examination,fundus examination under cycloplegia and optical coherence tomography before and after treatment.The preoperative and postoperative variables were compared by paired t-test,and the correlation between visual acuity and the macular thickness was analyzed by Pearson correlation test.Results Cataract surgery was completed successfully,and all patients were followed-up for (3-12) months,with an average (5.09 ± 2.20) months.The average BCVA of 101 eyes was increased from (0.12 ± 0.09)before surgery to (0.21 ± 0.16) after surgery,and the difference was statistically significant (t =-8.016,P =0.000).Postoperative visual acuity was significantly correlated with macular thickness.Furthermore,there was a negative correlation of macular thickness with macular cystoid edema,macular epiretinal membrane and visual acuity (r =-0.866,P =0.001),but a positive correlation with macular atrophy (r =0.928,P =0.000).Unfortunately,anterior capsule contraction occurred in 2 eyes after cataract surgery,and secondary intraocular hypertension appeared in 2 eyes.Visual acuity was improved and stable for a long time after radial incision of anterior capsule and medication control of intraocular pressure.Conclusion Phacoemuisification combined with intraocular lens implantation can improve the vision of patients,and is a safe and effective method for the treatment of retinitis pigmentosa complicated cataract.

The objective of this prospective study of the risks of treatment failure in patients with drug-susceptible pulmonary tuberculosis (PTB) was to provide reference data to help develop a disease control strategy. Participants were recruited in eight provinces of China from October 2008 to December 2010. A total of 1447 patients with drug-susceptible PTB and older than 15 years of age were enrolled. Demographic characteristics, bacteriological test results, and patient outcome, i.e., cure or treatment failure were recorded and compared using the chi-square or Fisher's exact tests. Multivariate logistic regression was used to identify factors associated with risk of treatment failure. Of the 1447 patients who were enrolled, 1349 patients (93.2%) were successfully treated and 98 (6.8%) failed treatment. Failure was significantly associated with age 365 years [odds ratio (OR)=2.522, 95% confidence interval (CI): (1.097-5.801)], retreatment [OR=2.365, 95% CI: (1.276-4.381)], missed medicine [OR=1.836, 95% CI: (1.020-3.306)], treatment not observed [OR=1.879 95% CI: (1.105-3.195)], and positive culture result after the first [OR=1.971, 95% CI: (1.080-3.597)] and second month [OR=4.659, 95% CI: (2.590-8.382)]. The risk factors associated with treatment failure were age 365 years, retreatment, missed medication, treatment not observed, and positive culture at the end of month 1 or month 2. These risk factors should be monitored during treatment and interventions carried out to reduce or prevent treatment failure and optimize treatment success.
Adolescent ; Adult ; Aged ; Antitubercular Agents ; therapeutic use ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; drug effects ; physiology ; Prospective Studies ; Retreatment ; Risk Factors ; Treatment Failure ; Tuberculosis, Multidrug-Resistant ; drug therapy ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; drug therapy ; epidemiology ; microbiology ; Young Adult

OBJECTIVETo observe the effect of chronic arsenic exposure on cerebral cortex and serum metabolics of mice and explore the mechanism of arsenic neurotoxicity.

METHODSTwelve 3-week-old male C57BL/6J mice were randomly assigned into exposure group and control group and exposed to sodium arsenite (50 mg/L) via drinking water and deionized water for 12 weeks, respectively. After the exposure, arsenic level in the cerebrum was determined by hydride generation-atomic fluorescence spectrometry. The metabolites in the cerebral cortex and serum were determined using gas chromatography-mass spectrometry (GC/MS) analysis. Principal component analysis (PCA) was used to analyze the difference of the metabolites between the exposure and the control groups. Online tools for analyzing metabolic pathways were used to identify the related metabolites pathways.

RESULTSArsenic content in the brain of exposure group was significantly higher than that in the control group (P<0.05). The mice exposed to arsenic had a higher level of citric acid, phenylalanine, tyrosine, histidine and lysine in the cerebral cortex (P<0.05). Serum levels of serine, glycine, proline, aspartate and glutamate were significantly higher while α-ketoglutaric acid level was significantly lower in the exposure group than in the control group (P<0.05). PCA analysis showed a significant difference in cerebral cortex and serum metabolites between the two groups.

CONCLUSIONChronic arsenic exposure may affect the function of the central nervous system by interfering with amino acid metabolism and tricarboxylic acid cycle, which may be one of the mechanisms of arsenic neurotoxicity.

Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Palpation ; Tonsillar Neoplasms ; diagnosis ; secondary

BACKGROUNDAccurate knowledge of the spinal structural functions is critical to understand the biomechanical factors that affect spinal pathology. Many studies have investigated the human vertebral motion both in vitro and in vivo. However, determination of in vivo motion of the vertebrae under physiologic loading conditions remains a challenge in biomedical engineering because of the limitations of current technology and the complicated anatomy of the spine.

METHODSFor in vitro validation, a human lumbar specimen was imbedded with steel beads and moved to a known distance by an universal testing machine (UTM). The dual fluoroscopic system was used to capture the spine motion and reproduce the moving distance. For in vivo validation, a living subject moved the spine in various positions while bearing weight. The fluoroscopes were used to reproduce the in vivo spine positions 5 times. The standard deviations in translation and orientation of the five measurements were used to evaluate the repeatability of technique. The accuracy of vertebral outline matching with metallic marks matching technology was compared.

RESULTSThe translation positions of the human lumbar specimen could be determined with a mean accuracy less than 0.35 mm and a mean repeatability 0.36 mm for the image matching technique. The repeatability of the method in reproducing in vivo human spine six degrees of freedom (6DOF) kinematics was less than 0.43 mm in translation and less than 0.65° in rotation. The accuracy of metallic marks and vertebral outline matching did not show significant difference.

CONCLUSIONSCombining a dual fluoroscopic and computerized tomography imaging technique was accurate and reproduceable for noninvasive measurement of spine vertebral motion. The vertebral outline matching technique could be a useful technique for matching of vertebral positions and orientations which can evaluate and improve the efficacy of the various surgical treatments.

Biomechanical Phenomena ; Fluoroscopy ; methods ; Humans ; In Vitro Techniques ; Lumbar Vertebrae ; anatomy & histology ; physiology ; Middle Aged ; Spine ; anatomy & histology ; physiology

Aged, 80 and over ; Dyspnea ; etiology ; Glottis ; pathology ; Hematoma ; complications ; Hemophilia A ; complications ; Humans ; Laryngeal Diseases ; complications ; Male

Background and Objective: Chemotherapy regimen containing anthracyclines has been used as the standard treatment for acute myeloid leukemia (AML). This study was to compare the efficacy and toxicity of the chemotherapy regimen containing perarubicin (THP) with that containing mitoxantrone (MIT) for young patients with newly diagnosed AML. Methods: A total of 129 patients with newly diagnosed AML, aged 16 to 60 years olds, were assigned for induction chemotherapy containing one to two courses with standard-dose cytarabine (Ara-C) and an anthracycline antibiotic, THP or MIT. When complete remission was achieved after induction therapy, the patients received two courses of consolidation therapy identical to the induction regimen. From then, the patients were alternately given four courses of consolidation therapy consisting of Ara-C/I-HP or Ara-C/MIT every three weeks. Maintenance treatment continued for three years when patients were in continuous complete remission (CCR). Results: Twenty-six out of 42 patients (61.90%) receiving THP therapy, and 48 out of 73 patients (65.75%) treated by MIT achieved CR (P>0.05). Nine (34.61%) and 11 (22.92%) out of CR patients treated by THP and MIT, respectively, relapsed within one year (P= 0.28). Moreover, the incidences of toxicities, such as infection, nausea/ vomiting and cardiac events, were similar in these two groups (P>0.05) except for alopecie, which was 26.19% in the THP group compared to 42.47% in the MIT group (P<0.01). Conclusions: Regimen containing THP plus Ara-C can be used for young adults with newly diagnosed AML for remission induction, but it is not superior to the regimen with MIT. Consolidation chemotherapy with THP or MIT is feasible for young adults with AML after CR.