Medicine
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To investigate the diagnostic value of multimodal ultrasound imaging composed of conventional ultrasonography (US), contrast-enhanced ultrasonography (CEUS), and shear wave elastography (SWE) for liver tumors. Between October 2017 and October 2019, US, CEUS, and SWE examinations of a total of 158 liver tumors in 136 patients at The First Affiliated Hospital of Nanchang University were performed. The histopathological or imaging diagnostic results were used as controls to evaluate the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of US, CEUS, SWE, and multimodal ultrasound imaging, which combines these 3 modes, in the differential diagnosis of benign and malignant liver tumors. ⋯ The areas under the receiver operating characteristic curve for US, CEUS, SWE, and multimodal ultrasound imaging in the diagnosis of benign and malignant liver tumors were 0.760, 0.897, 0.829, and 0.968, respectively. US, CEUS, and SWE all have diagnostic value in the diagnosis of benign and malignant liver tumors. Multimodal ultrasound imaging could significantly increase the accuracy of the diagnosis of benign and malignant liver tumors and has higher value for clinical application.
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Observational Study
Impact of tenofovir antiviral treatment on survival of chronic hepatitis B related hepatocellular carcinoma after hepatectomy in Chinese individuals from Qingdao municipality.
The impact of different antiviral regimen on prognosis of chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored. A total of 479 CHB-related HCC patients after curative liver resection were enrolled receiving tenofovir (TDF, TDF group) or lamivudine, telbivudine, and entecavir (non-TDF group). Both the overall survival and diseases-free survival were analyzed and compared. ⋯ Multivariate analysis showed that TDF treatment (P = .04), AFP level (P = .03) were significant independent factors associated with overall survival of CHB-related HCC patients. While TDF treatment (P = .04) and serum AFP level (P = .03) were independent factors associated with disease-free survival. Anti-virus treatment with TDF benefits for both overall survival and disease-free survival of CHB-related patients than other Nucleos(t)ide analogues.
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In the study's early stage, the research group had established an evaluation index system for the rational drug use of primary nephrotic syndrome in children. To assess the feasibility of the established index system, we conducted this empirical study. The cross-sectional study was conducted by using the Hospital Information System to extract some general clinical data of hospitalized children with primary nephrotic syndrome, which included registration number, age, sex, diagnosis and medication, etc. ⋯ The most common is respiratory infections, such as the bronchopneumonia, the mycoplasma pneumonia, etc. This study had successfully completed the measurement of the evaluation index system for the rational drug use of primary nephrotic syndrome in children. All indicators are feasible, but the operability and applicability need further research and improvement.
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Observational Study
Using next-generation sequencing to analyze Helicobacter pylori clones with different levofloxacin resistances from a patient with eradication failure.
The regimens containing levofloxacin (LVX) have been recommended as an alternate to standard triple therapy to treat Helicobacter pylori infections and H pylori mixed infection always lead to H pylori chronic infection. Although the molecular mechanism of LVX resistance with gyrA gene mutation has been clearly understood in H pylori, other genes involved in antibiotic resistance remain unclear. Efflux pump plays an important role in clinically relevant multidrug resistance. ⋯ The mutation pattern of the Asn87Lys of the gyrA gene confers a higher resistance to LVX than that of the Asp91Asn in H pylori. Increase in the number of SNVs of the Hp0970 (hefE) and Hp1329 (hefI) genes change the resistance to LVX. Twelve mutations verified by Sanger sequencing in Hp0970 (hefE) and Hp1329 (hefI) may decrease resistant levels to LVX.
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Case Reports
Intestinal tuberculosis in a patient with end-stage renal disease on hemodialysis: A case report.
Intestinal tuberculosis (TB) is rarely seen in patients with end-stage renal disease (ESRD). We report an intestinal TB case with a clinical presentation similar to that of colon cancer in a patient with ESRD on hemodialysis. ⋯ If non-specific uremic symptoms persist in patients with advanced CKD, the possibility of extrapulmonary TB such as intestinal TB must be considered. Also, in patients with radiologic suspicion of colon cancer, endoscopy with biopsy should be performed promptly to exclude colonic TB with similar clinical manifestations.