ObjectiveTo investigate the clinical features of Pulmonary Langerhans' cells histiocytosis (PLCH). MethodsFour cases of PLCH diagnosed by histopathologic examination between August 2004 and September 2013 were retrospectively analyzed. ResultsFour male patients aged from 19 to 46 year old, including three smokers. The main symptoms were chest tightness, cough, and dyspnea. Pneumothorax was presented in two cases, and tuberculosis was in one. The chest high resolution CT (HRCT) revealed lung cysts, nodles, and reticular changes predominantly in the upper and middle lung fields. The pathological Langerhans' cells infiltration were found in the histological biopsy of lesions of the 4 cases. All of the patients were positive in the immuno-histological staining for the S-100 and CD1a antigens. Two cases were positive in Langrin staining (other two patients didn't underwent the staining). Two of the 4 patients were given oral steroid, and the symptoms were improved in one of them. The case with pulmonary tuberculosis improved in symptoms and CT results showed the absorption of the lesion after anti-tuberculosis therapy. Three cases were not followed up. ConclusionPLCH patients were mainly young adults, often presented with chest tightness, cough, and dyspnea. The clinical features of chest HRCT are bilateral cysts, nodules and reticular changes. The disease may be defined by the finding of pathologic Langerhans' cells or the positive staining for CD1a antigens or Langerin.
Objective To explore the value of procalcitonin (PCT) in differential diagnosis of invasive candidiasis. Methods PubMed, Embase, Medline, Cochrane Library, China National Knowledge Infrastructure and Wanfang Data were searched for articles published from the dates of establishment of databases to January 2021. A prospective and retrospective cohort studies and a case-control studies of PCT in differential diagnosis of invasive candidiasis were collected. RevMan 5.3 software QUADAS-2 risk assessment tool was used to evaluate the quality of the literature. Meta-Disc 1.4 software was used to determine whether the original data had threshold effect and heterogeneity. Stata 14.0 software was used to analyze meta, judge publication bias and draw Deeks diagram. Results A total of 9 articles and 943 patients were included. There were 259 cases in candida group and 684 cases in control group. The study showed that the total sensitivity was 0.86 [95% confidence interval (CI) (0.80, 0.91)], specificity was 0.78 [95%CI (0.70, 0.84)], positive likelihood ratio was 3.92 [95%CI (2.77, 5.55)], negative likelihood ratio was 0.18 [95%CI (0.12, 0.27)], the area under receiver operator characteristic curve was 0.90 [95%CI (0.87, 0.92)], diagnostic odds ratio was 19.75 [95%CI (10.71, 36.43)]. The results of heterogeneity test showed that there was heterogeneity caused by non-threshold effect between studies. The results of subgroup analysis showed that the heterogeneity I2 value of PCT<2 ng/mL subgroup decreased significantly, and the result was more stable, with sensitivity. The results show that sensitivity was 0.86 [95%CI (0.79, 0.91)], specificity was 0.72 [95%CI (0.63, 0.80)], the area under receiver operator characteristic curve was 0.87 [95%CI (0.83, 0.89)]. Conclusions Serum PCT in the differential diagnosis of invasive candidiasis has certain accuracy and negative predictive value. However, PCT is only an auxiliary test. The differential diagnosis of invasive candidiasis should be combined with clinical features and other diagnostic indexes.
To evaluate the biomechanical action of lateral malleolar’s anatomical hook-plate in treatingWeber A-type ankle fracture. Methods Forty-eight cadaveric specimens of adult’s inferior extremities from June 2005to October 2006 were observed, consisting of 26 males and 22 females and aged 18-55 years. The external malleolus of the specimens were transected by using a wire saw at the ankle joint level, and then were divided into 4 groups randomly (groups A, B, C and D). Four distinct internal fixation instruments were used: lateral malleolar’s anatomical hook-plate in group A, general screws in group B , 1/3 tubular plate in group C and standard tension band in group D. Each group was further divided into 2 subgroups, A1-D1 and A2-D2. A1-D1 groups underwent anti-pressure and A2-D2 groups underwent anti-torsion biomechanically comparative analysis. Results The peak values of anti-pressure experiments in groups A1-D1 were (799.83 ± 105.47), (699.17 ± 63.81), (598.83 ± 123.14) and (453.00 ± 111.67) N respectively, group A1 was significantly higher than groups B1, C1 and D1 (P lt; 0.01); meanwhile, the peak values of anti-torsion experiments in groups A2-D2 were (37.17 ± 1.81), (30.33 ± 2.22), (20.50 ± 2.92), (24.83 ± 3.47) Nm respectively, group A2 was significantly higher than groups B2, C2 and D2 (P lt; 0.01). Conclusion The lateral malleolar’s anatomical hook-plate represents a definite biomechanical superiority, when compared with other 3 internal fixation instruments in treating fracture of external mlleolus.
ObjectiveTo compare social function of schizophrenic patients of different marriage status and breeding status. MethodsA total of 218 people diagnosed to have schizophrenia between June and December 2013 were investigated. The research instruments included General Status Questionnaire and Social Disability Screening Scale. ResultsMen had no significant difference in social deficit from women (P>0.05). At the onset of the disease, married male patients were better than single male ones in terms of social function retreating and family function (P<0.05); married female patients were better in all aspects of social function than single female ones (P<0.05); male patients with children were better in family function than those without children (P<0.05); female patients without children had much worse social dysfunction than those with children except in the area of activity outside the family (P<0.05); male patients without children had more obvious social dysfunction than those with children except in such areas as little activity within the family, personal care, external interests and concern (P<0.05); single female patients had worse social dysfunction than married ones at present (P<0.05). ConclusionMarried schizophrenic patients with children have better social function.
Objective To analyze the clinical pathogenic characteristics of children with co-infected pneumonia, and to provide reference for clinical diagnosis and treatment. Methods Children with co-infected pneumonia treated in the pediatrics department of the First Affiliated Hospital of Chengdu Medical College between June 2023 and May 2024 were selected. According to age, the children were divided into goups of infants, toddlers, preschoolers, school-aged children, and adolescents. The clinical pathogenic characteristics of children with pneumonia were analyzed. ResultsA total of 358 pediatric patients were included. Among them, there were 189 males (52.79%) and 169 females (47.21%); 71 (19.83%) were infants, 74 (20.67%) were toddlers, 113 (31.56%) were preschoolers, 75 (20.95%) were school-aged children, and 25 (6.98%) were adolescents. There was no statistically significant difference in the composition of males and females among different age groups or types of pneumonia (P>0.05). The bacteria detected were mainly Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis and Streptococcus pneumoniae. Viruses in the pathogen mainly included adenovirus, influenza A and B stream, human rhinovirus and respiratory syncytial virus. The main atypical pathogen detected was Mycoplasma pneumoniae (240 cases). Except for atypical pathogens (P>0.05), the detection rates of bacteria and viruses among different age groups showed statistically significant differences (P<0.05). The compositions of bacterial co-infections, viral co-infections, bacterial+viral infections, and co-infections involving atypical pathogens were compared among different age groups, and the difference was statistically significant (P<0.05). The proportions of different types of pathogens detected in winter were the highest. Conclusions Children with co-infected pneumonia are mainly aged 0-6 years old. The incidence of co-infected pneumonia in children is the highest in winter. Mycoplasma is the main pathogen in dual infections or co-infections. Co-infections in early childhood are mainly caused by bacterial infections, and the incidence of viral infections increases with age.