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25 December 2020, Volume 19 Issue 06 Previous Issue    Next Issue

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Correlation between gene polymorphism of chromosome 3q26 rs12696304 and 1-year survival rate after acute heart failure in an elderly Han population in South China ZHANG Zhongwen, ZUO Xiangrong, ZHENG Xuhui, CAO Quan, Li Xinli, LI Yanxiu 2020, 19 (06):  565-571.  DOI: 10.16150/j.1671-2870.2020.06.004 Abstract ( 162 )   HTML ( 0 )   PDF (682KB) ( 42 )   Objective: To investigate the correlation between the gene polymorphism of rs12696304 in chromosome 3q26 and 1-year survival rate in the patients with acute heart failure (AHF). Methods: A total of 336 elderly patients of Han population in South China (aged≥60 years) with AHF were enrolled during March 2012 and April 2016. DNA of each patient was extracted from peripheral blood, and the gene polymorphism of rs12696304 was analyzed by real-time fluorescence quantitative PCR with TaqMan probe. One-year survival rate was compared between the patients with diffe-rent gene typing in multiple genetic models using Kaplan-Meier and log-rank test. The Cox regression analysis was used to assess relation between the gene polymorphism of rs12696304 and 1-year survival rate in the patients with AHF. Results: In the co-dominant genetic model, the 1-year survival rate of the AHF patients carrying heterozygous CG genotypes was lower than that of patients carrying wild homozygous GG genotypes (74.8% vs 85.4%, P=0.027). In the dominant genetic model, 1-year survival rate of the AHF patients carrying CG+CC genotype was significantly lower than that of patients carrying the wild homozygous GG genotype (74.9% vs 85.4%, P=0.023). Further Cox regression analysis showed that the risk of 1-year death in the AHF patients carrying CG+CC genotype was 2.45 times of that in the patients with GG genotype (HR=2.45, 95%CI: 1.22-4.95, P=0.012) after adjustment with the relevant variables in codominant model, and in the dominant model, the risk of 1-year death was also 2.45 times of that in patients with GG genotype (HR=2.45, 95%CI: 1.24-4.84, P=0.010). Conclusions: The gene polymorphisms of rs12696304 located in chromosome 3q26 region may be associated with the 1-year prognosis in the patients with AHF. Figures and Tables | References | Related Articles | Metrics

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Epidemiological analysis of human papilloma virus infection in male patients with condyloma acuminatum during 2017-2018 in Shanghai WANG Juan, LI Jia 2020, 19 (06):  572-576.  DOI: 10.16150/j.1671-2870.2020.06.005 Abstract ( 240 )   HTML ( 2 )   PDF (472KB) ( 74 )   Objective: To investigate the epidemiological characteristics of human papilloma virus (HPV) infection in male patients with condyloma acuminatum in Shanghai, and to provide evidence for prevention and treatment of the disease. Methods: A total of 2 202 male patients with condyloma acuminatum diagnosed in the dermatology clinic of our hospital were enrolled between March 2017 and March 2018, and HPV infection status was explored. The HPV genotypes in skin lesion were tested with polymerase chain reaction (PCR)-reverse dot blot hybridization. Results: It showed 1 136 out of 2 202 patients were HPV DNA positive and positive rate was 51.59%. The positive rates of low-risk HPV 6 and 11 were 42.78% and 27.02%, while the high-risk HPV 16, 52 and 51 were 12.06%, 10.83% and 7.22% respectively. In 1 136 cases with positive HPV DNA, single infection was the main pattern with a positive rate of 56.78%. In patients with multiple HPV infection, double infection was the main form, accounting for 25.62%. It showed that 44.45% patients were infected with low-risk genotypes of HPV (single,double or triple HPV genotype infection), 34.07% patients had mixed infection of high-risk and low risk genotypes ( up to ten infections); 21.48% were only high-risk HPV infection (up to six infections). The positive detection rate in 41-60 year group was the highest (60.35%), which was significantly higher than the groups of ≤20 year and 21-40 year (all P<0.05, χ2=4.09 and χ2=13.57). Infection patterns among different age groups were as follows: 21-40 year patients were mainly infected by one single genotype,and majority patients in both≤20 year and ≥61 year group had multiple HPV infection. Conclusions: The detection rate of positive HPV DNA in male patient with condyloma acuminatum in Shanghai is 51.59%, and lower than the rates reported in Henan, Zhejiang and Dongguan(Guangdong), and the genotypes include HPV 6,11,16,52,51.The infection was mainly caused by single and low-risk HPV. Detection rate in 41-60 year male is the highest, and the proportion of multiple infections are higher in people ≤20 years and ≥61 years. Figures and Tables | References | Related Articles | Metrics

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Liposclerosing myxofibrous tumor: clinicopathologic analysis of 10 cases and review of literature JIN Jiaoying, JIANG Xiao, XU Ang, ZHANG Changbao, LI Qianyu 2020, 19 (06):  577-582.  DOI: 10.16150/j.1671-2870.2020.06.006 Abstract ( 325 )   HTML ( 2 )   PDF (925KB) ( 176 )   Objective: To explore the radiological and clinicopathologic characteristics of liposclerosing myxofibrous tumor (LSMFT). Methods: Ten patients diagnosed with LSMFT were enrolled during May 2015 to 2019 in our hospital, and the data including the manifestations, imaging and pathological characteristics were studied retrospectively, and related literatures were reviewed. Results: There were 7 male and 3 female in 10 cases and the average age of onset was 49 years (22-68). All cases showed non-specific clinical symptoms, in which 7 cases complained local pain in lower limb and swollen joint and 2 cases had walking difficulty, while 3 cases didn't show any symptoms. As consistent with literatures, most lesions (8/10) located in the proximal femur or the intertrochanteric region, and 2 lesions were in the proximal tibia. The CT and X-ray images showed a geographic osteolytic lesion with intramedullary eccentric shape or along femur longitudinal axis. The lesions had clear edges, nonhomogeneous density or sclerotic margin. MRI showed the lesions had relatively homogeneous signal on T1WI, and heterogeneously high signal intensity on T2WI with fat suppression. Microscopically, LSMFT was characterized with diversely histologic pattern. The myxofibrous areas, bone trabeculae similar to fibrous dysplasia (FD) and irregular calcification were found in all cases (10/10), and lipomatous areas, Pagetoid bone, xanthoma cells and cyst formation were showed in 7/10, 6/10, 2/10, 1/10 cases, respectively. All patients were treated with curettage and no recurrence were reported during 1-60 month follow-up. Conclusions: LSMFT is a rare benign fibro-osseous lesion with unique radiological features and multiple pathological structures,characterized with myxofibrous areas, irregular calcification and bone trabecula similar to FD. LSMFT should be distinguished from FD and bone infarction. Figures and Tables | References | Related Articles | Metrics

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The diagnostic value of smart three-dimensional superb microvascular imaging in differentiating benign and malignant breast lesions of BI-RADS 4 LI Weiwei, WU Ying, ZHOU Wei, ZHAN Weiwei, ZHOU Qinghua, TAO Lingling, YANG Yanwen 2020, 19 (06):  583-587.  DOI: 10.16150/j.1671-2870.2020.06.007 Abstract ( 211 )   HTML ( 1 )   PDF (510KB) ( 57 )   Objective: To study the efficacy of smart three-dimensional superb microvascular imaging (Smart 3D SMI) on displaying blood flow in breast lesions of breast imaging reporting and data system(BI-RADS）4, and analyze the diagnostic value of smart 3D SMI in BI-RADS 4 breast lesions. Methods: A total of 120 breast lesions of BI-RADS 4 confirmed by post-operative pathology were enrolled, and the lesions were divided into benign group (32 lesions）and malignant one (88 lesions). The power Doppler flow imaging (PDFI), advanced dramatic flow imaging (ADFI） and Smart 3D SMI were performed to detect blood flow in the lesions. Referring to the semi quantitative grading method, the blood flow levels in the lesions were divided into two groups: the group lack of blood flow and the group rich of blood flow. The difference in blood flow displayed by PDFI, ADFI and Smart 3D SMI was compared between the benign and malignant breast lesions. Furthermore, the results of Smart 3D SMI were used to correct the BI-RADS classification. The area under receiver operator characteristic curve(ROC curve) for performance of corrected BI-RADS to diagnose malignant breast lesions was compared before and after correction. Results: ALL these three methods showed that the blood flow in malignant lesions were more abundant than that in benign group (P<0.001, P<0.001, P=0.004). The distribution of blood flow levels detected by different detection methods was different. The proportion of patients with abundant blood flow detected by Smart 3D SMI method was 75.0% (benign 18 cases, malignant 72 cases), while it was 50.0% (5 cases of benign and 55 cases of malignant) by PDFI and 56.7% (7 cases of benign and 61 cases of malignant) by ADFI, respectively. There was no significant difference in distribution of blood flow levels between PDFI and ADFI (P=0.301). The percentage of patients with abundant blood flow detected by Smart 3D SMI was significantly higher than that by PDFI (50.0%, P<0.001) and ADFI (56.7%, P=0.004). Corrected with Smart 3D SMI, the BI-RADS classification of 52 cases with malignant lesions (59.1%) up-graded and 14 cases with benign lesion (43.8%) up-graded. The area under ROC curve of corrected BI-RADS for diagnosing malignant lesions was 0.86, which was higher than that of BI-RADS without correction (area under curve 0.80) (P=0.011). Conclusions: The Smart 3D SMI is a new method and have more advantage than traditional methods in detecting blood flow of BI-RADS 4 breast lesions, especially in the diagnosis of malignant tumors. Figures and Tables | References | Related Articles | Metrics

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Diagnostic value of colonoscopic narrow-band imaging for the colon polypoid lesions with diameter<2 cm and analysis of misdiagnosis WU Youwei, ZHANG Jian, ZHAO Suping, LÜ Samei, SHI Liping 2020, 19 (06):  588-593.  DOI: 10.16150/j.1671-2870.2020.06.008 Abstract ( 165 )   HTML ( 2 )   PDF (793KB) ( 210 )   Objective: To study the diagnostic value of colonoscopic narrow-band imaging (NBI) for colon polypoid lesions with the diameter <2 cm. Methods: A total of 86 patients with the colon polypoid lesions diagnosed in our hospital during February 2018 to February 2019 were enrolled. Routine enteroscopy and colonoscopic NBI were performed in the patients, and the morphology of colonpolypoid lesions including the overall lesion, glandular opening type and capillary were observed, and the images were assessed with clarity score. Biopsy specimens obtained during performing colonoscopy were analyzed by pathological examination, and the diagnostic efficacy of NBI were assessed by comparing the results of pathological examination. Results: A total of 104 colon polypoid lesions were detected among 86 patients, and the diameters of lesions were 0.1-2.0 cm and the average value was（0.72±0.34） cm. The NBI International Colorectal Endoscopic(NICE) classification of lesions were summarized as follows: 39 (37.50%) colon polypoid lesions were type 1, 57 (54.81%) lesions were type 2 and 8 (7.69%) were type 3. There were no significant difference in the morphological characteristics of colon polypoid lesions between the different NICE types (P>0.05). The pathological examination showed that there were 38 non-neoplastic polyps (36.54%) and 66 neoplastic polyps (63.46%). The sensitivity, specificity and accuracy rate of colonoscopy for diagnosing the neoplastic polyps were 81.82%, 81.57% and 81.73%, respectively, while the values of NBI colonoscopy were 92.42%, 89.47% and 91.35%. The diagnostic efficacy between two methods were different (P<0.05). Further analysis showed that the diagnostic sensitivities of NBI colonoscopy for neoplastic polyps with the diameter<1cm and 1-2 cm were 92.59% and 92.31%, the specificities were 86.67% and 91.30%, and the accuracy rates were 90.48% and 91.94%. The consistency Kappa values of enteroscopy and colonoscopic NBI with results of pathology for the neoplastic polyps of different diameters were 0.793 and 0.829, respectively. The causes for misdiagnosing colon polypoid lesions by colonoscopic NBI were insufficient bowel preparations and blurred display of microstructure. Conclusions: Compared with the colonoscopy, the accuracy of NBI colonoscopy for diagnosing colon polyps is improved. The NBI colonoscopy is worth to be applied in clinical practice since it has high diagnostic value for colon polypoid lesions with the diameter <2 cm and also shows high accuracy for judging the characteristic of lesions with the diameter <1 cm. Figures and Tables | References | Related Articles | Metrics

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Risk factors for hypoxia during performing gastroscopy with propofol sedation LIN Yuxuan, ZHAO Yanhua, WANG Xiaojing 2020, 19 (06):  594-599.  DOI: 10.16150/j.1671-2870.2020.06.009 Abstract ( 287 )   HTML ( 3 )   PDF (527KB) ( 67 )   Objective: To investigate the incidence and risk factors of hypoxia during performing gastroscopy with propofol sedation and provide theoretical basis for preventing hypoxia. Methods: From November 2017 to February 2018, a total of 1 000 outpatients undergoing routine gastroscopy with propofol sedation were enrolled,and the incidence of hypoxia and the other adverse events were recorded during performing gastroscopy. The patients were divided into two groups: hypoxia group and non-hypoxia group, and the general information, gastroscopy procedure and anesthesia related information were analyzed. Results: The incidence of hypoxia was 8.4% during gastroscopic examination. It revealed that the history of hypertension and snoring, elderly age, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, shorter thyromental distance, number of passing the gastroscope through the pharyngeal, high dose of propofol and low baseline of SpO2 were risk factors for occurrence of hypoxia during performing gastroscopy with propofol sedation (P<0.05). Age (45-65 years old, OR=2.903, 95% CI: 1.399-6.026,>65 years old, OR=5.495, 95% CI: 2.124-14.211), the dose of propofol (80-100 mg, OR=3.289, 95%CI: 1.215-8.906; 101-120 mg, OR=5.881, 95%CI: 1.964-17.615; >120 mg, OR=7.717, 95%CI: 2.664-22.351) and lower baseline of SpO2 (<95%, OR=3.327, 95% CI:1.173-9.439) were independent risk factors for hypoxia. Conclusions: Elderly patients (over 65 years old), the patients obtaining high dose of propofol (>120 mg) and with lower baseline SpO2 (<95%) have increased risk of hypoxia during gastroscopic examination with propofol sedation, and the hypoxia should be actively prevented and interfered. Figures and Tables | References | Related Articles | Metrics

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Value of serological parameters of thyroid function in combination with ultrasound examination for differentiating Graves disease from Hashimoto thyroiditis in children LI Songtao, YANG Daheng, SUN Hang, YUE Yulin, ZHANG Qian, LIU Qianqi, WU Su, MA Changyan 2020, 19 (06):  600-604.  DOI: 10.16150/j.1671-2870.2020.06.010 Abstract ( 134 )   HTML ( 1 )   PDF (542KB) ( 115 )   Objective: To analyze the serological parameters of thyroid function and features of ultrasound examination in pediatric patients with Graves' disease (GD) and Hashimoto thyroiditis (HT) so as to provide evidence for the differential diagnosis of the two diseases. Methods: A total of 226 children (aged from 7-14 years) from January 2016 to December 2019 at Children's Hospital of Nanjing Medical University were enrolled, including 124 GD children (GD group) and 102 HD (HD group). HD children were further divided into HT with hyperthyroidism (HT with hyperthyroidism group, 38 cases) and HT with hypothyroidism (HT with hypothyroidism group, 64 cases). Two hundred healthy children with matching age were served as controls. Free triiodothyronine（FT3）, free thyroxine（FT4）, thyroid stimulating hormone (TSH）, anti-thyroid peroxidase autoantibody（anti-TPOAb）, anti-thyroglobulin antibody（anti-TGAb） and thyroid stimulating hormone receptor antibody（TRAb） were detected with electrochemiluminescence immunoassay（ECLIA）. Indices of ultrasonography including transverse diameter and anteroposterior diameter of right and left lobes of thyroid, isthmic anteroposterior diameter were measured, and blood flow in thyroid was detected by color Doppler flow imaging (CDFI). Both the thyroid function serological parameters and features of ultrasound examination were compared between the four groups. Results: Compared with HT with hyperthyroidism group, GD group had an increased TRAb level [(18.98±20.11） IU/mL vs. (0.33±0.41) IU/L] but lower levels of anti-TPOAb [(176.10±188.84) IU/mL vs. (219.65±203.66) IU/mL] and anti-TGAb[(242.40±632.15) IU/mL vs. (471.56±361.12) IU/mL]. A further analysis showed that the positive rate of TRAb in GD group was higher than that in HT with hyperthyroidism group, while HT with hyperthyroidism group had higher positive rates of anti-TPOAb（93% vs 52%） and anti-TGAb（84% vs 49%）. Percentage of GD group with rich blood flow detected by CDFI（94%） was higher than that of HT patients with hyperthyroidism group(35%）(P<0.05). Conclusions: GD pediatric patients have similar clinical features and size of thyroid with those of HT with hyperthyroidism, which make it difficult to differentiate. Patients with higher TRAb level and abundant blood flow by CDFI imply a high possibility of GD, while those with increased levels of anti-TPOAb, anti-TGAb and non-abundant blood flow by CDFI are likely to have HT with hyperthyroidism. CDFI may provide reference for distinguishing GD from HT with hyperthyroidism Figures and Tables | References | Related Articles | Metrics

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The association between fatty liver index and microalbuminuria in middle-aged and elderly population in Shanghai ZUO Guangmin, PENG Kui, LI Mian, XU Min, BI Yufang, NING Guang 2020, 19 (06):  605-609.  DOI: 10.16150/j.1671-2870.2020.06.011 Abstract ( 204 )   HTML ( 1 )   PDF (497KB) ( 60 )   Objective: To investigate the association between fatty liver index (FLI) and prevalence of microalbuminuria. Methods: A cross-sectional survey of 4 012 subjects aged 40 years or older in Songnan Community, Shanghai was conducted in 2009. Questionnaire and anthropometric measurements were collected, and microalbuminuria and the FLI were determined. The association between FLI and microalbuminuria was analyzed. Results: Among the 3 415 subjects in the current analysis, the prevalence of microalbuminuria increased with increase of the FLI. The corresponding prevalence of microalbuminuria were 6.86%, 10.99% and 15.28% in low FLI group(FLI<30), intermediate FLI group(30≤FLI<60) and the high FLI group(FLI≥60), respectively (P<0.000 1). After adjustment for age, sex, smoking status, current drinking, physical activity, systolic blood pressure, diabetes and total cholesterol, the high FLI group was associated with 58% increased risk of microalbuminuria compared with the low FLI group (OR=1.58, 95% CI 1.17-2.15, P=0.003 2). In the same adjusting model,the risk in prevalence of microalbuminuria increased 10% for each 10 unit increase in FLI (OR=1.10, 95% CI 1.04-1.15, P=0.000 2). Conclusions: FLI increas is associated with increased risk of microalbuminuria in subjects aged 40 years or older in Songnan Community, Shanghai. Figures and Tables | References | Related Articles | Metrics