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    25 August 2020, Volume 19 Issue 04 Previous Issue    Next Issue
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    Original articles
    Diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy for different thyroid carcinoma in 10 388 thyroid nodules: a ten-year study
    WANG Xing, WANG Ronghui, ZHANG Guiping, DONG Yijie, ZHOU Wei, ZHAN Weiwei
    2020, 19 (04):  359-363.  DOI: 10.16150/j.1671-2870.2020.04.007
    Abstract ( 256 )   HTML ( 1 )   PDF (516KB) ( 116 )  

    Objective: To investigate the diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy (US-FNAB) in different subtypes of thyroid carcinoma. Methods: A total of 10 388 thyroid nodules from 9 933 patients undergone US-FNAB in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2010 to December 2019 were enrolled, and related data were retrospectively analyzed. The sensitivity, specificity, accuracy, positive and negative predictive value of US-FNAB for thyroid carcinoma were assessed by comparing to the results of surgical pathology. The accuracy rate of diagnosis between different subtypes of thyroid carcinoma was further analyzed. Results: The ten-year study revealed that among 10 388 nodules, 9 379 nodules were malignant. The total sensitivity, specificity, positive and negative predictive value of US-FNAB for thyroid carcinoma were 95.4%, 84.7%, 98.4%, 65.9% and 94.4%, respectively. For the subtypes of thyroid carcinoma, diagnostic accuracies for papillary carcinoma and medullary carcinoma were 95.8% and 69.4%, respectively. Conclusions: US-FNAB is valuable in the diagnosis of thyroid nodules and has the highest diagnostic accuracy for thyroid papillary carcinoma.

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    The study on molecular basis of ABO blood subgroups in the Chinese population
    LEI Hang, FAN Liangfeng, CAI Xiaohong, WANG Yuqing, LIU Xi, JIN Sha, SHEN Wei, LU Qiong, XIANG Dong, WANG Xuefeng, ZOU Wei
    2020, 19 (04):  364-369.  DOI: 10.16150/j.1671-2870.2020.04.008
    Abstract ( 618 )   HTML ( 6 )   PDF (579KB) ( 370 )  

    Objective: To explore distribution and molecular basis of ABO blood subgroups in Chinese population by analyzing phenotype-genotype correlations of ABO subgroups. Methods: Phenotype investigations were performed using serology studies in 1 545 505 blood donors and 116 209 blood recipients enrolled from April 2014 to June 2019, and the DNA sequence of the ABO gene was analyzed by direct sequencing or sequencing after cloning. Results: Serologic typing revealed that ABO subgroup were detected in 617 individuals, with an overall incidence of 3.71/10 000. Subgroup B(A) showed the highest detection rate(0.066‰), and was followed by B3(0.045‰) and Bx (0.039‰). A total of 42 ABO subgroup alleles were identified in 544 individuals by direct sequencing. According to the results of sequencing, ABO*BA.04 was the most common allele, with a constituent ratio of 25.20%, and then ABO*BA.02(11.55%) and ABO*cis-AB.01(9.71%). Correlation analysis revealed that corresponding phenotype of ABO subgroup alleles might differ from result of first testing, which meant a certain genotype could show multiple different phenotypes. Conclusions: Incidence of ABO blood subgroups in Chinese population is 3.71/10 000. B(A) subgroup is the most common in Chinese population and followed by B3 and Bx related subgroups. The common subgroup alleles are ABO*BA.04,BA.02 and cis-AB.01.

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    The application of thrombin generation test for assessing hemorrhagic tendency in patients with von Willebrand disease
    LIANG Qian, LU Zhengjing, SHAO Yanyan, DING Qiulan, WANG Hongli, WANG Xuefeng
    2020, 19 (04):  370-374.  DOI: 10.16150/j.1671-2870.2020.04.009
    Abstract ( 342 )   HTML ( 6 )   PDF (496KB) ( 133 )  

    Objective: To assess the value of thrombin generation test (TGT) for predicting hemorrhagic tendencyin patients with von Willebr and disease (vWD). Methods: A total of 38 vWD patients from Shanghai Ruijin Hospital during January 2018 to July 2019 were enrolled, and were divided into three groups: mild bleeding group (8 mild bleeders, type 1 patients), moderate bleeding group (14 moderate bleeders, including 8 type 2A patients and 6 type 2M patients) and severe bleeding group (16 severe bleeders, including 2 type 2N patients, 6 severe type 1 patients and 8 type 3 patients). Five healthy subjects in the same age were served as the control group. Platelet-poor plasma samples were prepared by centrifugation. The difference in thrombin-generating capacity between patients and controls were tested by TGT, which was activated with 1 pmol/L tissue factor(TF) and 5 pmol/L TF, respectively. The correlations of vWF∶Ag, vWF∶Act, FⅧ∶C with TGT parameters [Peak value, endogenous thrombin potential (ETP), time to peak (ttPeak)] were also studied. Results: Under 1 pmol/L TF activation, the Peak value of TGT in controls was significantly higher than those in mild, moderate and severe bleeders (P<0.000 1), and the Peak value in severe bleeders was significantly lower than those in mild and moderate cases. (P=0.000 1). Furthermore, ETP and ttPeakvalues showed significant difference between severe bleeding group and the other groups. While TGT was activated with 5 pmol/L TF, the difference in TGT parameters decreased between groups. There was no significant difference in Peak values between controls and mild bleeders, and ETP and ttPeakvaluesdid not differ significantly between the groups (P>0.05). In addition, FVIII∶C levels had a good correlation with Peak values measured at 1 pmol/L TF activation (R2=0.65), whilev WF∶Ag and vWF∶Act were weakly correlated with any of TGT parameters at 1 pmol/L or 5 pmol/LTF activation (R2<0.50). Conclusions: Activated with 1 pmol/L TF, Peak value of TGT may serve as a useful laboratory tool to evaluate thehemorrhagic tendency in different types of vWD.

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    The effect of intestinal flora on catch-up growth of small for gestational age detected by high throughput sequencing of 16S rRNA gene in rats and its possible mechanism
    AN Jingjing, WANG Junqi, XIAO Yuan, LU Wenli, LI Lin, WANG Wei, DONG Zhiya
    2020, 19 (04):  375-380.  DOI: 10.16150/j.1671-2870.2020.04.010
    Abstract ( 293 )   HTML ( 2 )   PDF (590KB) ( 113 )  

    Objective: To explore the effect of intestinal flora on catch-up growth in the rats of small for gestational age (SGA) and study the possible mechanism on catch-up growth (CUG) mediated by intestinal flora. Methods: SGA model was established by half dietary restriction during the pregnancy in female rats. A total of 54 baby rats were collected and were divided into two groups at the 4th week according to whether the rats achieved CUG or not: non-catch-up growth SGA (NCUG-SGA) group and CUG-SGA group. The serum insulin-like growth factor-1(IGF-1) in baby rats were measured with enzyme-linked immunosorbent assay (ELISA), the fecal intestinal flora was investigated by Illumina sequencing of 16S rRNA gene amplicons, and the level of fecal short-chain fatty acid (SCFA) and was tested by gas chromatography-mass spectrometer(GC-MS), respectively. The difference in composition of the intestinal flora, the level of fecal SCFA and serum IGF-1 were compared between 2 groups. Results: The level of IGF-1 in CUG-SGA group was significantly higher than the NCUG-SGA group[(250.41±85.66) μg/L vs(112.29±32.26) μg/L, P<0.05] in baby rats. Simpson's diversity index for intestinal flora in CUG-SGA group was markedly higher than NCUG-SGA group. The level of fecal SCFA in CUG group was higher than NCUG group(P<0.05). SCFAs were correlated with relative abundance of 11 types of differentially expressed bacteria genus in CUG-SGA group(|r|>0.6, P<0.05). Meanwhile,the levels of propionate, butyrate,isobutyrate and valerate were positively correlated with body weight and length as well as the serum level of IGF-1 in CUG-SGA rats. Conclusions: Intestinal flora exerts an effect on CUG in SGA rats. It may be achieved through regulating energy metabolism and absorption by SCFA,which produced by intestinal flora metabolism in the body.

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    Pulmonary microcystic fibromyxoma: a case analysis of clinical pathology and review of literature
    XU Haimin, CHEN Xiaoyan, ZHANG Jing, YANG Xiaoqun, WANG Chaofu
    2020, 19 (04):  381-385.  DOI: 10.16150/j.1671-2870.2020.04.011
    Abstract ( 252 )   HTML ( 0 )   PDF (1049KB) ( 206 )  

    Objective: To investigate the clinical manifestations, pathological features, immunophenotype and diffe-rential diagnosis of pulmonary microcystic fibromyxoma(MFM). Methods: The clinical manifestations, histopathological features, and immunophenotype were analyzed retrospectively in a patient diagnosed as pulmonary MFM, and the related literature was reviewed. Results: A 63-year-old man was detected to have lung nodule located in upper left lobe by routine X-ray examination. The chest CT showed multiple nodules in different sizes and the largest one located in the upper left lobe with smooth borders and mild enhancement. The resection of left upper lobe in lung was performed for the patient. Grossly,the big tumor located close to the edge of the lobe and the size was about 1.5 cm×1.1 cm×0.7 cm. It was grayish red, soft and had relatively clear border. Microscopically, the tumor had clear edge, and extensive microcapsule structures were observed. The cell showed the shapes of spindle or stellate without cellular atypia or mitotic figures. The tissue had a lot myxoid stroma, abundant small blood vessels and scattered lymphocytes, plasma cells,mast cells and macrophages. The other small tumor (maximum diameter of 0.2 cm) with similar morphology was 0.2 cm away from the larger one. Its' immunophenotype showed that the tumor cells were diffuse vimentin positive, and Ki-67 labelling index was low(<1%). The immunohistochemical markers for epithelial cells, muscle cells, nerve cells, neuroendocrine cells, vascular endothelial cells, and mesothelial cells were all negative. The chromosome translocation was not observed in EWSR1 gene by fluorescence in situ hybridization. The chest CT scans of the patient were repeated 12 and 18 months post the surgery and showed the number and size of multiple small nodules in right lung increased slightly. Conclusions: Pulmonary MFM is a rare mesenchymal tumor, and histologic structure is characterized with presence of microcapsule and myxoid stroma, and the tumor cells were vimentin positive. The diagnosis of pulmonary MFM depends on the morphologic observation and immunohistochemical staining. So far, the recurrence or metastasis has not been reportedyet, however, the imaging follow-up of this case shows the nodules slightly increased in numbers and size, which suggests that pulmonary MFM may have malignant potential.

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    Comparative analysis of ultrasonographic features and clinicopathological types for mucinous breast carcinoma and analysis of the causes for misdiagnosis
    YAN Bing, WANG Haifei, CAO Yunyun, NIU Jianmei
    2020, 19 (04):  386-390.  DOI: 10.16150/j.1671-2870.2020.04.012
    Abstract ( 348 )   HTML ( 2 )   PDF (528KB) ( 317 )  

    Objective: To explore the ultrasonographic and pathological features for different types of mucinous breast carcinoma(MBC), and to analyze the causes for ultrasonic misdiagnosis. Methods: A total of 68 MBC patients with 70 lesions were enrolled, and ultrasonographic manifestations, clinical data and pathological results were analyzed retrospectively. Results: Among 68 patients aging from 30-86 years old (54.5±23.3 years old), 40 cases (58.8%) were over 50 years old.Pathology examination revealed that pure MBC accounted for 57.4% (39/68), and the other cases were mixed MBC(42.6%,29/68); 16.2% of patients(11/68) had lymph node metastasis. Among the 70 lesions, 41.4%(29/70) were located on the right breast, 58.6% (41/70) on the left breast. In addition, the locations of 41.4%(29/70) lesions were outside the upper quadrant. Irregular morphology was observed in 76.9% (30/39) of pure MBC lesions, and in 80.6% (25/31) of mixed MBC lesions.Lobulated pure MBCs were more than mixed MBCs(25 cases to 7 cases)(P<0.05). There was 48.7% (19/39) of pure MBC lesions with unclear boundary, while there was 77.4%(24/31) of mixed MBC lesions with it. Both pure MBC and mixed MBC lesions showed more posterior acoustic enhancement on ultrasonography [74.4%(29/39) and 48.4% (15/31), respectively]. Blood flow were detected in 71.8% cases (28/39) of pure MBC and in 80.6% cases(25/31) of mixed MBC.The pure MBC and mixed MBC lesions that were classified as suspicious or malignant by BI-RADS accounted for 87.2% (34/39) and 93.5% (29/31) respectively, and the misdiagnosis rates were 12.8% (5/39) and 6.5% (2/31). The misdiagnosed masses were characterized by regular morphology, the clear boundaries and the absence of posterior acoustic enhancement,which accounted for misdiagnosis. Conclusions: The ultrasonic manifestations of MBC have certain relationship with pathological type of MBC. The lesions of pure MBC are usually lobulated with unclear boundary and enhancement of posterior acoustic features, which make it difficult to distinguish between benign and malignant lesions. Mixed MBC presents with more aggressive imaging characteristics on the ultrasonography.

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    Superb microvascular imaging in combination with ultrasonic elastography and high-frequency ultrasound in micro breast cancer:an assessment on the diagnostic efficacy and screening for high-risk features on ultrasound
    LU Yejun, CHEN Hui, ZHANG Jian, XU Bin, WANG Chong, HE Ye
    2020, 19 (04):  391-396.  DOI: 10.16150/j.1671-2870.2020.04.013
    Abstract ( 264 )   HTML ( 3 )   PDF (865KB) ( 140 )  

    Objective: To analyze the diagnostic value of superb microvascular imaging (SMI) in combination with ultrasonic elastography (UE) and high-frequency ultrasonography on micro breast cancer and screening for high-risk features on ultrasound. Methods: A total of 87 breast lesions from 85 patients were collected. The maximum diameters of the lesions were no more than 1 cm,and all lesions were classified as BI-RADS (Breast Imaging Reporting and Data System) 4. The lesions were grouped into benign and malignant groups based on results of postoperative pathology. The characteristics of grey-scale ultrasound and color Doppler flow imaging(CDFI), SMI and elasticity scores of the lesions were compared between 2 groups and high-risk features on ultrasound for micro breast cancer were screened. Results: Univariate analysis showed that lesion morphology, margin, calcification status, elasticity score, SMI and CDFI classification were statistically different between benign and malignant groups (P<0.05). Multivariate Logistic regression analysis revealed that lesions with ill-defined margin, elasticity score ≥4 or Adler scale of SMI ≥Ⅱ were independently predicting factors for micro breast cancer. The accuracy of combining the three indices for diagnosing micro breast cancer was 81.61%, higher than any single one. Conclusions: High-risk features of micro breast cancer on ultrasound include Adler scale SMI≥Ⅱ and elasticity score ≥4. Both features in combination with ill-defined margin show good diagnostic efficiency for micro breast cancer, which may provide an important reference for clinical diagnosis.

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    Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in elderly patients with hilar and mediastinal lesions and analysis of missed diagnosis
    HONG Guiping, CHEN Xiaoyan, ZHOU Jianping, CHEN Wei, XIANG Yi, ZHOU Min, LI Qingyun
    2020, 19 (04):  397-401.  DOI: 10.16150/j.1671-2870.2020.04.014
    Abstract ( 228 )   HTML ( 0 )   PDF (486KB) ( 124 )  

    Objective: To assess the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in elderly patients with hilar and mediastinal lesions. Methods: A total of 206 patients (≥ 65 years of age) hospitalized in the Department of Respiratory and Critical Care Medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were enrolled, and all had hilar or mediastinal lymphadenopathy, and/or paratracheal and bronchial masses detected on CT or PET-CT, and all had definite histopathologic findings (including percutaneous lung biopsy, thoracoscopy, open thoracic surgery, and superficial lymph node biopsy). The diagnostic efficacy of EBUS-TBNA was assessed by comparison with the pathologic findings as the gold standard and the cases with missed diagnosis were analyzed. Results: Of the 206 patients, 61 lesions had paratracheal and/or bronchial lesions aspirated, and 225 groups of lymph nodes aspirated via EBUS-TBNA. Pathological examination revealed that 151 patients had malignant disease and 55 patients had benign disease. EBUS-TBNA identified 140 cases out of 151 malignant tumors and 50 cases out of 55 benign lesions, respectively. The diagnostic sensitivity, specificity of EBUS-TBNA for malignant tumors were 92.7%, 100%, respectively and the missed diagnosis rate was 7.8%. The diagnostic sensitivity and specificity of EBUS-TBNA for benign lesions were 90.9%, 100%, respectively, and the missed diagnosis rate was 9.1%. The major causes for missed diagnosis included small lesions (diameter <1 cm), small tissue sample or small number of tissue samples to be examined. Conclusions: EBUS-TBNA is a safe and effective approach with high diagnostic sensitivity and specificity for elderly patients with hilar and mediastinal lesions. For lesions with negative result of EBUS-TBNA but lesion with average length or diameter <1 cm, missed diagnosis should be awared of.

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    Establishment of fluorescence PCR method using blood specimens for a rapid genetyping and its application in ADRB1 genotyping
    GONG Ruhan, LI Jia, HUANG Kaifeng
    2020, 19 (04):  402-406.  DOI: 10.16150/j.1671-2870.2020.04.015
    Abstract ( 233 )   HTML ( 2 )   PDF (652KB) ( 120 )  

    Objective: To establish a fluorescence PCR method using blood specimen for a rapid genetyping and apply it to the single nucleotide polymorphism(SNP) typing of ADRB1 (1165G>C) gene. Methods: The fluorescence PCR method using blood samples for gene amplification was established without extraction of blood genomic DNA, which was different from a traditional way. A total of 1 051 whole-blood samples anticoagulated with ethylene diamine tetraacetic acid (EDTA) were collected for ADRB1 (1165G>C) gene SNP typing. The performance of self-established method was assessed by comparison with results from Sanger sequencing method, and conformity and consistency (Kappa) between the two methods were calculated. Results: The method established in this research had better amplification performance. The overall typing coincidence rate of method established with Sanger sequencing reached 98.98%, and the Kappa consistency coefficient between them was 0.971. Conclusions: Compared with traditional methods, the method established in this research is easy to operate by omitting the step of genomic DNA extraction with low cost and high accuracy. It is suitable for popularization and application to clinical detection relate to genetyping.

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    Analysis of bone marrow lymphocyte subsets in patients with acute myeloid leukemia and its clinical significance
    GAO Yanting, ZHAO Jinyan, WANG Juan, LI Jia, XU Wen, LI Li, LIN Lihui
    2020, 19 (04):  407-413.  DOI: 10.16150/j.1671-2870.2020.04.016
    Abstract ( 368 )   HTML ( 4 )   PDF (882KB) ( 240 )  

    Objective: To investigate the distribution of bone marrow lymphocyte subsets in patients with acute myeloid leukemia (AML),and comparing the bone marrow immune function between patients at different stage of disease and with different prognostic risk, and exploring their related clinical significance. Methods: The bone marrow samples from 131 patients with AML before treatment were collected, and the lymphocyte subsets CD4+ T cells, CD8+ T cells and CD19+ B cells were identified by multi-color flow cytometry for determining the percentages of lymphocyte subsets and CD4+/CD8+ ratio. The results were compared with that of healthy bone marrow samples obtained from the public data platforms. The AML patients included de novo cases (94 cases), secondary cases (18 cases), and relapsing cases after chemotherapy (19 cases). The de novo AML were categorized into low risk, intermediate risk and high risk groups according to the cytogenetic abnormality. Differences in lymphocyte subsets between the three groups and between the three different risk levels were compared. In relapsing patients, the percentages of lymphocyte subsets at onset were compared with that at relapse. Results: Compared with healthy subjects, AML patients had a higher percentage of CD8+ T cells (31.73%±12.38% vs 21.40±7.33%, P<0.001) and lower percentage of CD19+ B cells ( 9.62% vs 14.03%, P<0.01) and lower ratio of CD4+/CD8+ (1.04 vs 1.48, P<0.05). When compared with de novo patients, relapsing patients had higher CD8+ T cells (41.56%±11.64% vs 29.86%±12.20%, P<0.001), but lower CD19+ B cells ( 4.18% vs 11.82%, P<0.05) and CD4+/CD8+ ratio (0.59 vs 1.12, P<0.05). Paired comparison showed that relapsing patients had significant lower percentage of CD19+ B cells than that at onset(2.40% vs 12.41%, P<0.05). There were no significant differences in distribution of lymphocyte subsets between different risk level groups of de novo AML. The percentages of NK cells between the three groups were not different significantly. Conclusions: The bone marrow of AML patients showes obvious suppression of humoral immunity and cellular immunity. The suppression of bone marrow immune function is obviously more severe in patients with relapsing AML than in de novo. It is suggested that the distribution of bone marrow lymphatic subsets may be an effective indicator for detecting and assessing the prognosis of the disease.

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    Functional study and detection of vimentin produced by miR-200c target gene in human gastric cancer BGC823 cells
    YANG Cuiping, YANG Xiaojin, YANG Yanpin, ZHANG Mengyin, XIE Ling, YU Xiaojun, CAI Boer, CHEN Dengyu, CHEN Ping, WU Yunlin
    2020, 19 (04):  414-419.  DOI: 10.16150/j.1671-2870.2020.04.017
    Abstract ( 226 )   HTML ( 0 )   PDF (777KB) ( 79 )  

    Objective: To investigate the expression of zinc finger E-box enhancer binding protein 2(ZEB2) gene in miR-200c in human gastric cancer BGC823 cells by RNA targeted interference technique, and detect expression of vimentin, so as to observe the effect of miR-200c on the function of gastric cancer BGC823 cells. Methods: The interference plasmids shZEB2 was constructed and transfected to BGC-823 cells in mediation of Lipofectamine 2000. The stable transfectants were screened by G418, and ZEB2 mRNA, miR-200c and vimentin was detected by real-time PCR in BCG823 cells, while protein expression levels of ZEB2 and vimentin by Western blotting. Proliferation of BGC-823 cells was evaluated by MTT assay. Transwell assay and wound healing assay were used to observe the invasion and migration ability of BCG823 cells, respectively. Results: With interfering ZEB2 expression, miR-200c expression level increased while proliferation, migration and invasion ability of BGC823 cells decreased significantly. Conclusions: ZEB2 may be the target of miR-200c, and the ability of BGC823 cells including proliferation, migration and invasion is significantly decreased after interference with ZEB2.

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    Detection rate of gastric polyps and its clinical characteristics in 36 857 subjects in Shanghai
    ZHOU Yufen, WONG Bokai, LUO Fangxiu, XU Ying, DING Yanfei, YUAN Xiaoqin, CHEN Ping, WU Yunlin
    2020, 19 (04):  420-425.  DOI: 10.16150/j.1671-2870.2020.04.018
    Abstract ( 377 )   HTML ( 0 )   PDF (632KB) ( 3660 )  

    Objective: To explore the detection rate of gastric polyp (GP) in Shanghai and analyze its clinical characteristics. Methods: A total of 36 857 subjects undergone gastroscopy during December 2012 to May 2019 were enrolled, and the detection rate of GP and related pathologic data were analyzed. Results: It revealed that 3 858 patients had GP, with a detection rate of 10.47%. In patients over 60 years old, 1 534 patients were diagnosed as having GP, with a detection rate of 14.75%. Compared with patients in other age groups (<30, 30-39, 40-49, 50-59 years), the constituent ratio of patients with GP diameter ≥2.0 was higher(1.8%)(P<0.05), so was with adenomatous polyps (1.9%) and with intraepithelial neoplasia (2.9%)(P<0.05). The only three cases with high-grade intraepithelial neoplasia were all ≥60 years old. Besides, the constituent ratio of patients ≥60 years old with atrophic gastritis and with intestinal metaplasia were 22.4% and 34.0%, respectively,which were higher than those of patients <60 years old. In contrast, GP patients ≥60 years old had a lower constituent ratio of Helicobacter pylori infection (15.1%), lower than that of patients under 60 years old (P<0.01). Conclusions: In comparison with the population <60 years old, population ≥60 had a higher detection rate of GP. GP patients of ≥60 years old had higher proportion of polyps diameter greater than 2 cm, adenomatous polyps, intraepithelial neoplasia, atrophic gastritis, and intestinal metaplasia. Therefore, more attention should be paid to the detection and pathology examination of GP in elderly patients.

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    Analysis of interference factors in measurement of serum uric acid by uricase-peroxidase coupled reaction
    ZHOU Xiaona, FANG Honggang, CAO Yanfei, LI Xinna, ZHANG Lina, LU Yide
    2020, 19 (04):  426-429.  DOI: 10.16150/j.1671-2870.2020.04.019
    Abstract ( 429 )   HTML ( 4 )   PDF (690KB) ( 315 )  

    Objective To explore the possible interference factors in the measurement of serum uric acid (UA)by uricase-peroxidase coupled reaction and the methods to eliminate these interference factors. Methods: Two cases with pseudo-hypouricemia detected by uricase-peroxidase coupled reaction were analyzed. Causes for interference on measurement were analyzed via alarm message and reaction curve displayed on the instrument. Different approaches were adopted to eliminate the interference on measurement of serum UA. Results: The initial measurement value of serum UA for case 1 was 18.2 μmol/L. According to the reaction curve, it was speculated that the low UA value might be caused by the admi-nistration of Rasburicase. Thereafter, the blood sample withdrawn from case 1 was recollected into pre-cooled heparin tube, and the corrected value was 102.0 μmol/L. The initial measurement value of serum UA of case 2 was a negative value, the reaction curve and appearance of protein precipitation in in-vitro test indicated that the internal M protein was suspected to lead to the false decrease of serum UA value. The UA value of case 2 was normalized to 158.5 μmol/L via the PEG6000 protein precipitation method. Conclusions: Measurement of serum UA by uricase-peroxidase coupled reaction may be affected by various exogenous and endogenous factors. When the UA value comes to be abnormal, comprehensive analysis of reaction curve is needed to confirm the interference factor, which helps to achieve more accurate test results in clinical setting.

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    The correlation of ocular Demodex folliculorum infection with secondary immunodeficiency diseases
    HONG Yufang, WU Yang, XU Yongtang, YAO Pengxiang, CHEN Zhenzong, MA Xiaoping
    2020, 19 (04):  430-433.  DOI: 10.16150/j.1671-2870.2020.04.020
    Abstract ( 167 )   HTML ( 0 )   PDF (497KB) ( 73 )  

    Objective: To investigate the correlation between ocular Demodex folliculorum infection and secondary immunodeficiency diseases. Methods: A total of 192 patients with secondary immunodeficiency diseases from Xiamen Branch, Zhongshan Hospital, Fudan University during November 2019 to January 2020 were enrolled, including patients with malignant tumors, chronic kidney disease, diabetes, and autoimmune diseases. Two hundred and forty-six visited patients without secondary immunodeficiency diseases were served as controls. The eye lashes were taken and examined under optical microscope to observe the status of Demodex folliculorum infection. Results: Demodex folliculorum was found in 162 of 192 patients (84.4%) with secondary immunodeficiency diseases and 150 of 246 controls(61.0%)(P<0.05). Among these subjects, patients with diabetes had the highest infection rate (89.7%). The variable correlation analysis revealed that immunodeficiency diseases was positively correlated with Demodex folliculorum infection(r=0.256, P<0.001). Multivariate Logistic regression analysis showed that the secondary immunodeficiency diseases doubled the risk of ocular Demodex folliculorum infection (OR=2.09, 95%CI 1.25-3.47, P=0.005). Conclusions: Secondary immunodeficiency may be a high-risk factor for the ocular infection with Demodex folliculorum, and attention should be given to Demodex folliculorum examination in diabetes patients.

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