目的 探讨64 排螺旋CT冠状动脉成像（CTA）在冠状动脉狭窄诊断中的应用价值。 方法 选取2010年8月－2012 年8月间收治的90例临床诊断或疑似冠心病患者，所有患者均先实施64排螺旋CT冠状动脉CTA，然后所有患者实施常规冠状动脉造影，对比不同诊断方法的诊断结果，评估两种诊断方法对于冠状动脉狭窄的准确率及精确度。 结果 64 排螺旋CT冠状动脉CTA检出1处明显狭窄者36例，冠状动脉造影检出1处明显狭窄者36例，两组检查方法诊断冠状动脉狭窄对比，差异无统计学意义（P＞0.05）。冠状动脉CTA诊断灵敏度为86.12%，特异度为94.21%，阳性预测值为80.33%，阴性预测值为97.11%，冠状动脉造影诊断灵敏度为72.19%，特异度为84.65%，阳性预测值为71.35%，阴性预测值为87.41%。冠状动脉CTA的诊断准确率高于冠状动脉造影，差异有统计学意义（P＜0.05）。 结论 64 排螺旋CT冠状动脉CTA诊断冠状动脉狭窄的准确度及灵敏度都较高，对早期轻度狭窄诊断灵敏度优于传统动脉造影，对于辅助患者治疗具有重要作用，值得在临床推广应用。
We analysed the profiles of teaching practice in clinical diagnostics for international students in recent three years in West China School of Medicine, Sichuan University. Teaching experiences and characteristics were summarized through the following five aspects:pre-service training for all teachers, textbook selection and lesson plan formulation, teaching style and problem-based learning, as well as teaching feedback. We aimed to improve the quality of medical education for international students. Our teaching practice can offer better clinical skills and correct clinical analysis ability for international students in West China School of Medicine, which should be a great help for their further career development.
Objective To summarize the research progress of gastric schwannoma (GS). Methods GS related researches and case reports were collected to make a review on general clinical manifestations, pathology characteristics, auxiliary examinations, differential diagnosis, and treatment. Results GS is rare in clinical reports, and it is lack of tissue specificity. Diagnosis is rely mainly on the expressions of S-100 protein and glial fibrillary acidic protein (GFAP). All kinds of auxiliary examinations, such as gastrointestinal angiography, ultrasound, endoscope, CT, an so on, could not independently as a diagnostic basis. Identification between GS and other gastric tumors is difficult, and GS is not sensitive to radiation and chemotherapy, the main treatment is surgery. Conclusions GS is a kind of rare tumor which occurs in gastric mucosa, immunohistochemistry is the most main examination for the diagnosis of GS. The surgical excision is the main treatment for GS, but the safety and efficacy of combination therapy of laparoscopy and endoscopy remains to be study.
Objective To comprehensively observe, recognize, learn and understand the clinical features of tuberculous meningitis (TBM). Methods We retrospectively analyzed the general data, clinical manifestations, clinical examinations and treatment prognosis of 152 patients with TBM who were hospitalized in the Second Affiliated Hospital of Zunyi Medical College between January 2016 and February 2017. Results The mean age of the 152 patients with TBM was (43.9±20.4) years old, the ratio of male to female was 1.45:1, and the average length of hospital stay was (20.0±18.9) days. The clinical manifestations were mainly headache [95.4% (145/152)], nausea and vomiting [42.8% (65/152)], and fever [61.8% (94/152)]. The main co-morbidities were secondary pulmonary tuberculosis [52.0% (79/152)], hematogenous disseminated tuberculosis [37.5% (57/152)], and tuberculous pleurisy [30.9% (47/152)]. The positive rate of γ-interferon release test was 90.8% (129/142), and the brain pressure of lumbar puncture was elevated. The typical biochemical changes of cerebrospinal fluid were " low glucose, low chlorine, and high protein”. The positive rate of tuberculosis smear was extremely low, and the positive rate of GeneXpert MTB/RIF in cerebrospinal fluid was 21.9% (7/32). The TBM patiens were prone to combine with hypoproteinemia, the proportion reached 29.6% (45/152), and the proportion of hyponatremia reached 45.3% (69/152). Treated with early diagnosis and treatment, 92.1% (140/152) improved and discharged. Conclusions TBM patients are mainly young and middle-aged with various clinical manifestations and less respiratory symptoms; and are easy to be combined with pulmonary tuberculosis and other extrapulmonary tuberculosis. γ-interferon release test and cerebrospinal fluid GeneXpert MTB/RIF can be used for the auxiliary diagnosis of tuberculosis. Early detection, early diagnosis and treatment, rational and regular chemotherapy, strengthening symptomatic supportive treatment, and improving the precise diagnosis and treatment of TBM, can improve its clinical prognosis.
ObjectiveTo explore the expression and clinical significance of plasma soluble podoplanin (sPDPN) in patients with colorectal cancer (CRC). MethodsTCGA-READ, TCGA-COAD datasets were obtained to compare expression level of PDPN mRNA in CRC tissues and adjacent tissues, and to explore the relationship between expression of PDPN mRNA and the prognosis of CRC patients. A total of 85 CRC patients (CRC group) underwent surgery in the Second Affiliated Hospital of Xuzhou Medical University from November 2020 to December 2022, and 100 healthy volunteers from the hospital were collected as a control group to detect the expression levels of plasma sPDPN of the two groups, and exploring the relationship between sPDPN expression and the clinicopathological characteristics of the CRC patients. The ROC curves of sPNPD, sugar antigen 199 (CA199) and carcinoembryonic antigen (CEA) were drawn simultaneously, and the predictive value of sPDPN for CRC was explored by logistic regression model. ResultsThe results of TCGA dataset showed that expression level of PDPN mRNA was upregulated in CRC tissues compared with adjacent tissues/paired adjacent tissues (P<0.05), and patients with high expression level of PDPN mRNA had better prognosis than low expression patients (P=0.045). The expression level of sPDPN was (3.50±1.77) ng/mL in CRC group, which was higher than (1.95±0.46) ng/mL of the control group (P<0.01). The expression level of sPDPN was higher in CRC patients at Ⅲ+Ⅳ clinical stage (P=0.026) and N1–2 stage (P=0.049). Compared with CA199 and CEA, sPDPN had the highest area uncer curve value of 0.882 (0.832, 0.932), and was an risk predictor of CRC [OR=14.769, 95%CI (5.867, 37.174), P<0.001]. ConclusionThe sPDPN is highly expressed in the plasma of CRC patients and has a certain clinical utility for diagnosis of CRC, and evaluation of clinical staging and lymph node metastasis.