Objective To understand research progress on peritoneal metastasis from gastric cancer at present stage briefly. Methods The literatures about mechanism, diagnosis, prevention and treatment of the peritoneal metastasis from gastric cancer at home and aboard were collected to make a review. Results The peritoneal metastasis is the common site of the distant metastasis in the advanced gastric cancer. It’s occurrence mechanism is complex, the diagnostic measure is varied, the prevention way is difficulty, and it give priority to with the comprehensive treatment and the transformed therapy. Conclusion It has a certain necessity to study occurrence mechanism, prevention methods and treatment measures so that improve survival rate and prognosis for patients with peritoneal metastasis from advanced gastric cancer.
Since the outbreak of coronavirus disease 2019, hospital laboratories have become an important place for testing all kinds of specimens of patients with suspected or confirmed coronavirus disease 2019. There may be a high load of severe acute respiratory syndrome coronavirus 2 in clinical specimens of confirmed patients, and the biosafety risk is high, so it poses a challenge to the hospital laboratory testing process. This paper compares the microbial pre-processing, culture, identification and drug sensitivity analysis of the traditional clinical microbial detection process and the fully automated microbial pipeline, expounds the biosafety risks of the traditional manual detection process of pathogenic microorganisms in the epidemic situation, and discusses the role and dilemma of the fully automated microbial pipeline in the biosafety assurance of the epidemic situation. The purpose is to provide a basis for the promotion of fully automated microbial pipeline in the future.
目的 评价UF-1000i全自动尿沉渣分析仪中沉渣定量模块中白细胞和细菌参数阈值在排除尿路感染的应用价值。 方法 选取2 580份清洁中段尿液, 同时进行细菌培养菌落计数和UF-1000i尿沉渣白细胞和细菌定量分析，建立ROC曲线确定白细胞参数与细菌参数阈值。 结果 以尿定量培养菌落计数G?菌≥105 cfu/mL，G+菌≥104 cfu/mL为阳性参考标准，当白细胞沉渣定量为100/μL时，UF-1000i尿沉渣分析仪检测灵敏度为64%，特异度为75%，阴性预测值为96%；当UF-1000i细菌计量为901/μL时，检测灵敏度为68.3%，特异度为92.8%，阴性预测值为97%。 结论 UF-1000i检测新鲜尿标本白细胞的测定值lt;100/μL，细菌值lt;901/μL时能够作为临床早期排除尿路感染的依据之一。
ObjectivesTo investigate the epidemiological and clinical characteristics of first diagnosed human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in a general hospital, so as to improve early recognition and diagnosis of HIV/AIDS.MethodsWe retrospectively analyzed the data of HIV/AIDS patients who were diagnosed for the first time and had medical records in West China Hospital of Sichuan University from January 2015 to December 2016. Epidemiological information, clinical characteristics and opportunistic infection of these patients were analyzed.ResultsThe 1 036 HIV/AIDS patients were mainly from other regions of Sichuan Province except Chengdu. The overall ratio of male to female was 3.26∶1, and the ages of the patients were mainly between 15 and 59 years old (83.20%). In the occupational distribution, household or unemployed accounted for the largest proportion (36.39%). In terms of education level, junior high school accounted for the largest proportion (27.70%). Among marital status, married accounted for the largest proportion (52.41%). Among ethnic groups, the Han nationality accounted for the largest proportion (87.64%). The main infection route was sexual transmission (82.05%), of which heterosexual transmission accounted for 65.64% and homosexual transmission accounted for 16.41%. The clinical departments of confirmed patients had a wide range of sources, the top five of which were General Outpatient Clinic, Infection Center, Department of Emergency, Department of Dermatology & Venerology and Department of Neurology. Of the patients, 66.99% reported asymptomatic, and 33.01% had one or more symptoms. The most common symptoms were systemic symptoms such as fever, fatigue and lymphadenopathy, as well as clinical manifestations of respiratory system, nervous system and gastrointestinal system. The clinical stage of HIV/AIDS patients were mainly asymptomatic phase and AIDS phase, accounting for 98.65%. Among the HIV/AIDS patients, there were obviously more medical patients than surgical patients. The most common symptoms of the medical patients were fever, cough and expectoration, headache, fatigue and abdominal pain. The main symptoms of the surgical patients were headache, abdominal pain and lymphadenopathy. Compared with the surgical HIV/AIDS patients, the medical patients were younger (Z=−2.647, P=0.008), and the platelet counts (t=−2.110, P=0.036) and CD4+ T lymphocyte counts (Z=−4.639, P<0.001) were lower, the differences were statistically significant. Compared with the homosexually transmitted HIV/AIDS patients, the heterosexually transmitted patients were older (t=25.477, P<0.001), and had lower CD4+ T lymphocyte counts (Z=−2.779, P=0.005). And in males, the red blood cell count and hemoglobin content were lower. There were 214 patients (20.66%) with opportunistic infections, and 50 patients (4.83%) with tumors.ConclusionsHIV/AIDS patients in this general hospital come from different clinic departments, and were mainly Han nationality and married men. Sexual transmission is the main transmission route. Common clinical presentations of HIV/AIDS include fever, fatigue, cough and expectoration, headache, abdominal pain and lymphadenopathy. The diagnosis and treatment of HIV/AIDS patients combined with opportunistic infections and tumors need more attention.
Objective To evaluate the performance of i3000 direct chemiluminescence detection of human immunodeficiency virus (HIV) antigen and antibody (Ag/Ab) screening assay (Maccura), compared with E170 electrochemiluminescence method (Roche, Elecsys® HIV Combi PT assay) and IS1200 indirect chemiluminescence method (Maccura). Methods Ten HIV seroconversion panels and 11 p24 antigen positive samples from West China Hospital of Sichuan University from April to December 2017 were used to evaluate the sensitivity of those three assays. A total of 351 samples were collected for consistency evaluation, including 350 HIV Ag/Ab test samples (200 HIV-1 positive plasma samples and 150 HIV 1+2 negative plasma samples) from West China Hospital of Sichuan University from April to December 2017, and one commercial HIV-2 sera. A total of 98 interfere samples for HIV testing were collected from West China Hospital of Sichuan University from April to December 2017. Results In the sensitivity evaluation, there were 63 samples from the 10 seroconversion panels, in which Roche E170 detected 25 samples, Maccura i3000 detected 23 samples, and Maccura IS1200 detected 22 samples; Maccura i3000 and Roche E170 assays detected all the p24 antigen positive samples (11, 100%), while Maccura IS1200 only detected 10 samples. In the consistency evaluation, Maccura i3000 had nice consistency with both Roche E170 and Maccura IS1200 (kappa>0.9, P<0.001). In the interference evaluation, there were two false positives in Maccura i3000 detection, one case of rheumatoid arthritis and one case of syphilis. Conclusion In addition to high throughput and good consistency, Maccura i3000 direct chemiluminescence reagent has high sensitivity and a short window period, which can meet clinical needs.
Human immunodeficiency virus (HIV)-1 p24 antigen is one of the earliest proteins appearing after HIV infection. It can be used as a diagnostic marker to shorten the detection “window period” to about 14 days. It is of vital importance in the process of early diagnosis and antiviral therapy monitoring. This review briefly describes the basic structure and clinical significance of detection of HIV-1 p24 antigen, focusing on the current domestic and foreign researches on the biosensors of HIV-1 p24 antigen based on new nanomaterials, in order to provide a reference for developing novel detection technology.
ObjectiveTo analyze the diagnostic efficacy of colloidal gold immunochromatography assay (GICA) in detection of SARS-CoV-2.MethodsUsing GICA detection kits from three different manufacturers, 33 serum samples were collected from 12 patients with SARS-CoV-2 infection at different time and 45 serum samples from 45 patients without SARS-CoV-2 infection were collected from West China Hospital of Sichuan University from January to February, 2020.ResultsThe sensitivity, specificity, positive predictive value and negative predictive value of the three GICA reagents were 66.7% - 90.9%, 73.3% - 100.0%, 71.4% - 100.0% and 80.4% - 91.7% respectively. The rates of missed diagnosis and misdiagnosis were 9.1% - 33.3% and 0 - 26.7%, respectively. The positive rate decreased with titer increasing. The interference factors mainly included human immunodeficiency virus infection, high rheumatoid factor blood samples, and hemolysis.ConclusionClinical laboratories should pay attention to the differences in the detection ability and potential cross-reaction of different reagents, or use a combination of multiple antibodies.
ObjectiveTo evaluate the clinical significance of human immunodeficiency virus (HIV) testing algorithm combining antigen/antibody assay screening with Western Blot (WB) or HIV nucleic acid.MethodsData of HIV antigen and antibody screening samples in West China Hospital of Sichuan University in 2018 were retrospectively analyzed. The 4th generation antigen and antibody reagents were used for initial screening, and the 3rd generation antibody reagents were used for reexamination. WB or HIV nucleic acid detection was performed as supplementary test.ResultsA total of 217 803 samples were initially screened, 718 samples were positive in initial screening (0.33%) and 513 samples were confirmed positive (0.24%). The 718 initial positive samples were confirmed by WB, among them, 513 (71.45%) were positive, 163 (22.70%) were negative, and 42 (5.85%) were indeterminate. Fifteen samples which were negative or indeterminate were detected by HIV RNA, as a result, 6 were positive. Two of four patients turned into positive during follow-up. Among the 536 samples which were positive in both the 4th and 3rd generation assay, there were 513 (95.71%) positive, 6 (1.12%) negative, and 17 (3.17%) indeterminate confirmed by WB; among the 182 samples which were positive in the 4th generation assay but negative in the 3rd generation assay, there were none (0.00%) positive, 157 (86.26%) negative, and 25 (13.74%) indeterminate confirmed by WB. The positive rate of confirmation test of samples positive in the 4th and 3rd generation assay (95.71%, 513/536) was significantly higher than that of samples positive in the 4th generation assay but negative in the 3rd generation assay (0%, 0/182), and the difference was statistically significant (χ2=610.091, P<0.001). WB band types for positive samples were dominated by the whole bands and sub-bands, accounting for 82.26%. The cut off index in ≥5 bands group was higher than that in < 4 bands group (P<0.001).ConclusionsSamples with both the 4th and 3rd generation assay positive have a high positive rate of confirmation test, and a supplementary test is needed to be done as soon as possible to confirm the diagnosis. Samples with only the 4th generation assay positive have a low positive rate of confirmation test. But for patients with a high-risk history, HIV nucleic acid should be done as soon as possible for early diagnosis.
Objective To analyze the drug resistance of Mycobacterium tuberculosis complex (MTBC) in West China Hospital of Sichuan University in recent years to provide reference for drug resistance monitoring and prevention strategies of tuberculosis in general hospitals. Methods The clinical strains of MTBC that performed drug susceptibility tests in West China Hospital of Sichuan University between January 2019 and December 2022 were collected. The drug susceptibility information of 13 anti-tuberculosis drugs, namely rifampicin, isoniazid, ethambutol, streptomycin, rifabutin, amikacin, kanamycin, ofloxacin, levofloxacin, moxifloxacin, para-aminosalicylic acid, ethionamide, and capreomycin, was collected and retrospectively analyzed. Results A total of 502 clinical strains of MTBC were included, and 366 of them were isolated from newly-treated patients while 136 form re-treated patients. The resistance rates of MTBC strains to the first-line anti-tuberculosis drugs in descending order were 28.69% (isoniazid), 19.72% (ethambutol), and 14.94% (rifampicin). Among the second-line drugs, the resistance rates to ofloxacin, levofloxacin, and moxifloxacin were 13.55%, 12.15%, and 11.95%, respectively. The resistance rates to amikacin, kanamycin, para-aminosalicylic acid, and ethionamide were all less than 10%. The resistance rates to streptomycin, capreomycin, and rifabutin were 17.53%, 13.55%, and 12.15%, respectively. The resistance rates to the remaining 12 anti-tuberculosis drugs except capreomycin of MTBC strains isolated from re-treated patients were higher than those of MTBC strains isolated from newly-treated patients, and the differences were statistically significant (P<0.05). The isolation rates of monodrug-resistant, polydrug-resistant, multidrug-resistant (MDR) and pre-extensively drug-resistant (pre-XDR) strains were 9.36%, 7.37%, 7.17%, and 7.77%, respectively. The isolation rates of strains with the four drug-resistant phenotypes generally showed a downward trend during the four years, and the changing trends were statistically significant (P<0.05). The isolation rates of MDR and pre-XDR strains from re-treated patients were higher than those from newly-treated patients, and the differences were statistically significant (P<0.001). Conclusion Tuberculosis drug resistance in West China Hospital of Sichuan University, which is a comprehensive tuberculosis-designated hospital, remained severe during the four years from 2019 to 2022, and the prevention of tuberculosis and the monitoring of drug resistance should be further strengthened.