Objective To investigate the feasibility of collecting exhaled breath condensate ( EBC)fromartificially ventilated patients with modified EcoScreen condenser. Methods ①In vitro test with lung simulator: the modified EcoScreen condenser was connected to lung simulator and mechanically ventilated for 60 min through three different types of connected tube as follows: dry ventilator pipe disconnected to humidifier, connected to the unheated humidifier, and connected to heated humidifier.Meanwhile, the changes of the peak pressure of inspiration ( PI) and tidal volume ( VT ) were observed. The volume of condensate was measured at last. ②In vivo test from artificially ventilated patients: 10 patients were artificially ventilated and their EBCs were collected with the modified EcoScreen condenser through dry pipe disconnected to humidifier for 20 min. The changes of PI, VT , respiratory frequency( f) , heart rate( HR) , mean arterial blood pressure ( MAP) , and blood oxygen saturation ( SpO2 ) were observed. Results ①In vitro test with lung simulator: At the end of the ventilating through the dry pipe disconnected to humidifier for 60 min,2. 2 mL condensate wascollected. Neither the change of PI or VT nor the obstruction of the collecting tube by iced condensate were observed. The ventilating through dry pipe connected to unheated humidifier had to stop at 50 min as the obstruction of the collecting tube caused by ice. 5 mL condensate was collected. It was observed that VTdecreased and PI increased. After ventilation through dry pipe connected to heated humidifier for 60 min,10. 5 mL condensate was collected while PI slightly increased and VT decreased. ② In vivo test from artificially ventilated patients: After ventilation through dry pipe disconnected to humidifier for 20 min, 2 mL EBC was collected without significance changes in PI, VT, f, HR, MAP, and SpO2 . Conclusions The modified EcoScreen condenser can be favourably applied to artificially ventilated patients for collecting EBC.It is recommended to performfor 20 min through the pipe disconnected to humidifier to obtain sufficient EBC without condensate dilution and airway obstruction. It is warranted more attention to the clinical and mechanical monitoring in this procedure.
Prostate cancer is a common disease in the USA and Europe, with a gradually increasing incidence in China, and presents a significant health burden for older men. The lack of modifiable risk factors has made early detection as a strategy to reduce mortality. Current methods of screening involve the measurement of serum prostate-specific antigen (PSA) and digital rectal examination followed by biopsy. With PSA screening evidence of level I absent, the evidence on the use of PSA as a screening test is still highly controversial. Furthermore, there is controversy over whether screen-detected lesions will become clinically significant. There are three major treatment options for localized disease: radical prostatectomy, radical radiotherapy and monitoring with treatment if required. There is no evidence of randomized controlled trial (RCT) to suggest a survival advantage of any of these treatments. Opinions about the related benefits and risks of screening vary widely. In the absence of RCT of benefit for screening, many now suggest “informed consensus” screening, which encourages a discussion between the patient and his physician with both sides informed of all of the issues.
ObjectiveTo systematically review the diagnostic efficacy of abbreviated magnetic resonance imaging sequence (AMRI) screening for hepatocellular carcinoma (HCC). MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on the diagnostic efficacy of AMRI screening for HCC from inception to March 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, meta-analysis was performed by using Stata 16.0 software. ResultsA total of 15 studies involving 2 823 participants were included. The results of meta-analysis showed that combined sensitivity and specificity of AMRI for HCC were 0.85 (95%CI 0.83 to 0.87) and 0.93 (95%CI 0.90 to 0.94). Subgroup analysis showed that, the combined sensitivity and specificity of NC AMRI and HBP AMRI were 0.84 (95%CI 0.81 to 0.87), 0.92 (95%CI 0.88 to 0.95) and 0.88 (95%CI 0.84 to 0.91), 0.93 (95%CI 0.91 to 0.94), respectively. The combined sensitivity and specificity of T2+DWI+HBP in HBP AMRI had the highest diagnostic efficacy. ConclusionCurrent evidence shows that all AMRI protocols have acceptable sensitivity and specificity for HCC screening. Among them, T2+DWI+HBP protocol shows the highest diagnostic efficiency. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Currently,lung cancer (LC) has one of the highest incidence rates among various malignant tumors worldwide,and the annual mortality rate of LC has ranked first among all malignant tumors. About 80% of LC patients present to the hospital in a late advanced stage and lose the chance of surgical resection. Among all the patients who receive surgical treatment,the 5-year mortality rate of patients with early TNM stages is far lower than that of patients with advanced stage LC. With the advancement of medical equipment and more people who receive routine medical examination,more and more patients with small pulmonary nodules are discovered. Limited lung resection,including wedge resection and segmental resection,can be performed with minimally invasive video-assisted thoracoscopic surgery for these patients to acquire equivalent surgical outcomes as traditional lobectomy and a much better postoperative quality of life. LC screening increases the chances of early detection and diagnosis of LC patients,so these patients can receive reasonable diagnosis and treatment at an early stage. This strategy can greatly reduce treatment cost and mortality,and achieve maximal treatment benefits with minimal economic and medical cost. This review focuses on the necessity,high-risk groups,evaluation criteria and methods of LC screening with some LC screening guidelines and research studies in order to provide reasonable and feasible screening strategies and references for clinical LC screening.
Objective To investigate the nutritional status of hospitalized patients with chronic kidney disease (CKD), analyze the influencing factors, and construct a predictive model to provide a localized theoretical basis and more convenient risk prediction indicators and models for clinical nutrition support and intervention treatment of CKD patients in China. Methods Convenience sampling was used to select hospitalized CKD patients from Department of Nephrology, West China Hospital, Sichuan University, from January to October 2019. General information questionnaires, the Nutritional Risk Screening 2002 scale, and the Huaxi Emotional-distress Index questionnaire were used for data collection. Single factor analyses and multiple logistic regression analysis were conducted to explore the risk factors for malnutrition in CKD hospitalized patients. A predictive model was established and evaluated using receiver operating characteristic (ROC) curve analysis and bootstrap resampling. Results A total of 1059 valid copies of questionnaires were collected out of 1118 distributed. Among the 1059 CKD hospitalized patients, 207 cases (19.5%) were identified as having nutritional risk. The multiple logistic regression analysis showed that CKD stage [odds ratio (OR)=1.874, 95% confidence interval (CI) (1.631, 2.152), P<0.001], age [OR=1.015, 95%CI (1.003, 1.028), P=0.018], and the Huaxi Emotional-distress Index [OR=1.024, 95%CI (1.002, 1.048), P=0.033] were independent risk factors for malnutrition in CKD hospitalized patients, while serum albumin [OR=0.880, 95%CI (0.854, 0.907), P<0.001] was an independent protective factor. The evaluation of the multiple logistic regression analysis predictive model showed a concordance index of 0.977, standard deviation of 0.021, and P<0.05. The area under the ROC curve was 0.977. Conclusions The prevalence of malnutrition is relatively high among CKD hospitalized patients. CKD stage, age, psychological status, and serum albumin are influencing factors for malnutrition in CKD hospitalized patients. The multiple logistic regression model based on the above indicators demonstrates good predictive performance and is expected to provide assistance for early nutritional intervention to improve the clinical outcomes and quality of life for CKD patients with malnutrition in China.
During the prevention and control of coronavirus disease 2019, West China Hospital of Sichuan University urgently set up 4 medical tents to conduct centralized screening of fever patients, effectively avoiding cross-infection, and at the same time alleviating the pressure on the Department of Emergency Medicine and improving the efficiency of medical treatment for patients with fever. Later, in order to actively respond to China’s severe acute respiratory syndrome coronavirus 2 nucleic acid detection policy, 5 tents were adjusted to carry out the severe acute respiratory syndrome coronavirus 2 nucleic acid detection. This article introduces the function setting, personnel arrangement and protective measures of medical tents in West China Hospital of Sichuan University during the prevention and control of coronavirus disease 2019. It aims to share the experience of urgently setting up medical tents in the prevention and control of coronavirus disease 2019, with a view to provide a reference for the construction of medical tents in other medical institutions.
ObjectiveTo evaluate the performance of nuchal translucency (NT) measurement in the first trimester of pregnancy as a marker for congenital heart defects (CHD).
MethodsFrom January 2010 to December 2012, middle-low risk pregnant women were prospectively evaluated at the Department of Ultrasound in West China Second Hospital of Sichuan University about Nuchal translucency and echocardiography.
ResultsNT measurements was performed in 2 443 women from 2 764 pregnancy women, and a total of 2 125 case could be used in data analysis. NT measurement >2.5 mm was found in 68 fetuses, and 11 cases were diagnosed as CHD (prevalence 5.2/1 000). The sensitivity and specificity of NT measurement >2.5 mm for CHD were 45.5% and 87%, respectively.
ConclusionIncreasing nuchal translucency might increase the risk of CHD in fetuses, and could be used as a method to diagnosis CHD.
ObjectiveTo systematically review the value of mass screening of serum pepsinogen test for Asian population with high-risk gastric carcinoma.
MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CNKI, WanFang Data, VIP and CBM for diagnostic tests on serum pepsinogen test versus with pathological biopsy/X-ray examination (gold standard) between January 2004 and January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using Meta-DiSc software (version 1.4).
ResultsA total of 15 studies involving 180 934 subjects were included. ROC curve showed "shoulder-arm shape" distribution. The results of Spearman correlation analysis suggested a significance of the threshold effect (P=0.001). The results of meta-analysis showed that, the area under curve (AUC) was 0.74.
ConclusionSerum pepsinogen has good value in the screening of gastric carcinoma among Asian permanent residents. Due to limited quality of studies, the above conclusion should be verified by conducting more high quality studies.
As the largest ecosystem of human body, intestinal microorganisms participate in the synthesis and metabolism of uric acid. Developing and utilizing intestinal bacteria to degrade uric acid might provide new ideas for the treatment of hyperuricemia. The fecal samples of people with low uric acid were inoculated into uric acid selective medium with the concentration of 1.5 mmol/L for preliminary screening, and the initially screened strains that may have degradation ability were domesticated by concentration gradient method, and the strains with high uric acid degradation rate were identified by 16S rRNA sequencing method. A strain of high-efficiency uric acid degrading bacteria was screened and domesticated from the feces of people with low uric acid. The degradation rate of uric acid could reach 50.2%. It was identified as Escherichia coli. The isolation and domestication of high efficient uric acid degrading strains can not only provide scientific basis for the study of the mechanism of intestinal microbial degradation of uric acid, but also reserve biological strains for the treatment of hyperuricemia and gout in the future.
Place cell with location tuning characteristics play an important role in brain spatial cognition and navigation, but there is relatively little research on place cell screening and its influencing factors. Taking pigeons as model animals, the screening process of pigeon place cell was given by using the spike signal in pigeon hippocampus under free activity. The effects of grid number and filter kernel size on the place field of place cells during the screening process were analyzed. The results from the real and simulation data showed that the proposed place cell screening method presented in this study could effectively screen out place cell, and the research found that the size of place field was basically inversely proportional to the number of grids divided, and was basically proportional to the size of Gaussian filter kernel in the overall trend. This result will not only help to determine the appropriate parameters in the place cell screening process, but also promote the research on the neural mechanism of spatial cognition and navigation of birds such as pigeons.
