AIM： To investigate the prevalence of and risk factors for lens opacities in populations living at two different altitudes in China.·METHODS： A total of 813 subjects aged ≥40y in Lhasa（Tibet Autonomous Region...AIM： To investigate the prevalence of and risk factors for lens opacities in populations living at two different altitudes in China.·METHODS： A total of 813 subjects aged ≥40y in Lhasa（Tibet Autonomous Region, China. Altitude： 3658 m） and Shaoxing（Zhejiang Province, China. Altitude： 15 m） were underwent eye examinations and interviewed in this cross-sectional study. Participants＇ lens opacities were graded according to the Lens Opacities Classification System II（LOCS II） and the types of opacities with LOCS II scores ≥2 were determined. Univariate and stepwise logistic regression were used to evaluate the associations of independent risk factors with lens opacities.· RESULTS： Lens opacities were significantly more prevalent in the high-altitude than in the low-altitude area（χ2=10.54, P 〈0.001）. Lens opacities appear to develop earlier in people living at high than at low altitude. The main types of lens opacity in Lhasa and Shaoxing were mixed（23.81%） and cortical（17.87%）,respectively. Independent risk factors associated with all lens opacities were age, ultraviolet（UV） radiation exposure,and educational level. Compared with participants aged40-49 y, the risk of lens opacities increased gradually from 2 to 85 times per 10 y [odds ratio（OR）=2.168-84.731,P 〈0.05）. The risk of lens opacities was about two times greater in participants with the highest UV exposure than in those with the lowest exposure（OR=2.606, P =0.001）.Educational level was inversely associated with lensopacities; literacy deceased the risk by about 25%compared with illiteracy（OR=0.758, P =0.041）.·CONCLUSION： Old age, higher UV exposure and lower educational level are important risk factors for the development of lens opacities. Lens opacities are more prevalent among high-altitude than low-altitude inhabitants.展开更多
Background Contrast sensitivity （CS） testing can detect differences in functional vision and is highly correlated with visual performance. This study was designed to investigate the association between CS and the gr...Background Contrast sensitivity （CS） testing can detect differences in functional vision and is highly correlated with visual performance. This study was designed to investigate the association between CS and the grading score using the lens opacities classification system （LOCS） III as well as the association between CS and visual acuity （VA） in nuclear or cortical age-related cataract （ARC） patients. Methods A total of 270 eyes with ARC and 30 control eyes were divided into nuclear opacity （NO）, nuclear color （NC）, cortical cataract （C） based on LOCS II1. The CS values measured at all spatial frequencies under photopic and glare conditions that resulted in contrast sensitivity function （CSF） were evaluated, and LogMAR VA was tested with the Early Treatment Diabetic Retinopathy Study （ETDRS） chart. The correlation between CSF and LOCS III grading scores, and between CSF and LogMAR VA were analyzed. Results Compared to the controls, CSF of the nuclear or cortical ARC significantly declined. There are significant correlation between CSF and LogMAR VA, and between CSF and LOCS III grading scores. Compared to the VA, a stronger correlation existed between CSF and LOCS III grading score than that of LogMAR VA and LOCS III grading score. CS at some spatial frequencies is significantly influenced with LOCS III grading score. Conclusions CSF significantly declined with the increasing ARC grading scores. Comparing to VA, CSF reflected the severity of cataract more comprehensively. CS at low spatial frequency is significantly influenced by ARC. Therefore, CS is more precise than VA in assessing the visual function of ARC patients.展开更多
The study was conducted to determine the role of radiological investigation in assessing the severity of COVID-19 pneumonia with the help of chest X-ray (CXR), high resolution computed tomography (HRCT), and ultrasoun...The study was conducted to determine the role of radiological investigation in assessing the severity of COVID-19 pneumonia with the help of chest X-ray (CXR), high resolution computed tomography (HRCT), and ultrasound. This was a retrospective study conducted on 105 COVID-19 patients with symptoms of fever, cough, dyspnea, loss of sense of smell and taste, body ache. Diagnostic tests PCR were positive for COVID-19 included from Medicare Cardiac and General Hospital and Jinnah Medical College Hospital Korangi (JMCH) from April to November 2020. Written informed consent was taken from all participants. This study was approved by ethical review committee, Jinnah Medical & Dental College. Real time-PCR (RT-PCR) was done for the confirmation. Radiological imaging including Chest X-ray, HRCT chest, and ultrasound was done to study the severity of symptoms. Sixty-five patients had mild to moderate symptoms with oxygen saturation between 96% - 98% and 30 patients with severe pneumonia had between saturation 50% - 55%. Patients with mild symptoms were followed up by chest X-ray showing mostly normal chest X-rays but single or patches of ground glass opacities (HRCT). HRCT of 10 patients with low oxygen saturation 50% were already done showing bilateral peripheral patchy consolidation predominantly involving mid and lower lobes. 3 patients presented with patchy lung opacities and ultrasound showing similar findings with pleural effusion and ascites. Radiological imaging, specially CT-Scan was highly significant for diagnosing COVID-19 and severity of infection even in patients with negative PCR. Chest X-ray and ultrasound were also found to be a very useful tool.展开更多
Purpose: Age-related lens opacity is the main cause of vision disablitity in elderly population all over the world. This study was designed to investigate the prevalence and incidence of lens opacity.Methods: 1817 eye...Purpose: Age-related lens opacity is the main cause of vision disablitity in elderly population all over the world. This study was designed to investigate the prevalence and incidence of lens opacity.Methods: 1817 eyes of 932 adults over 45 year-old were sampled randomly from 4 villeges within Doumen, a county located in the south of Guangdong provience, China. The procedure of the examination was performed by ophthalmologists. The lens opacities were graded according to a standarized photo of the Lens Opacities Classification System II (LOGS- II ).Results: The prevalence of lens opacities in nuclear color, nuclear opacity, cortical opacity and subcapsular opacity was 16. 1% , 28.,6% , 30. 3% and 8. 7% , respectively. The frequency of all four types of opacities increased with age. The prevalence of lens opacities in four types was higher in female than that in male. Conclusion: The data we got are important for prevalence of lens opacities of population-based study as well as basic information for展开更多
Pneumonia is a common complication in organ transplantation patients. Multiple respiratory pathogens such as bacteria, viruses and fungi are potentially coexisted. A 60-year-old male with left eye post corneal transpl...Pneumonia is a common complication in organ transplantation patients. Multiple respiratory pathogens such as bacteria, viruses and fungi are potentially coexisted. A 60-year-old male with left eye post corneal transplantation developed acute severe pneumonia caused by <em>Pneumocystis jiroveci</em> (PJP) coinfection with <em>Nocardia spp</em>. and <em>Cytomegalovirus</em> (CMV). He was hospitalized due to acute respiratory failure. Chest radiographs and chest Computed Tomography (CT) revealed extensive ground-glass opacities. PJP was diagnosed from Bronchoalveolar Lavage Fluid (BALF). The pneumonia was persistent despite of receiving intravenous cotrimoxazole. Tracheal aspirate showed faint gram-positive filamentous beaded branching organisms. Consequently <em>Nocardia spp</em>. was proven. Intravenous cotrimoxazole was continued and intravenous imipenem was added. After a course of dual antibiotics, pneumonia was gradually improved. A week after, he developed the worsened acute respiratory failure. The bronchoscopy was performed. The new pathogens were not detected from BALF microbiology. The BALF cytology was unremarkable. PJP was detected by Polymerase Chain Reaction (PCR) from BALF. CMV antigenemia was detected from BALF and blood. Intravenous ganciclovir was given. This report describes PJP coinfected with <em>Nocardia spp</em>. and CMV in post corneal transplantation patient suffering from severe pneumonia. Multiple respiratory pathogens are common among transplantation patients representing host immunosuppression and inadequate antimicorbial prophylaxis.展开更多
The X^3Σg^-,A^'3△u,A^3Σ^u+,1^3Πg,and B^3Σu^-electronic states of oxygen molecule(O2)are calculated by the multiconfiguration self-consisted filed(MRCI)+Q method with the scalar relativistic correction and cor...The X^3Σg^-,A^'3△u,A^3Σ^u+,1^3Πg,and B^3Σu^-electronic states of oxygen molecule(O2)are calculated by the multiconfiguration self-consisted filed(MRCI)+Q method with the scalar relativistic correction and core-valence correlation correction.The obtained spectroscopic constants of the low-lying bound states are in excellent agreement with measurements.Based on the accurately calculated structure parameters,the opacities of the oxygen molecule at the temperatures of 1000 K,2000 K,2500 K,and 5000 K under a pressure of 100 atm(1 atm=1.01325×10^5 Pa)and the partition functions between 10 K and 10^4 K are obtained.It is found that with the increase of temperature,the opacities for transitions in a long wavelength range are enlarged because of the larger population on excited electronic states at the higher temperatures.展开更多
BACKGROUND Circulating tumor cells(CTCs) can be clustered into three subtypes according to epithelial-mesenchymal transition(EMT) markers: CTCs with epithelial markers(E-CTCs), CTCs with mesenchymal markers(M-CTCs), a...BACKGROUND Circulating tumor cells(CTCs) can be clustered into three subtypes according to epithelial-mesenchymal transition(EMT) markers: CTCs with epithelial markers(E-CTCs), CTCs with mesenchymal markers(M-CTCs), and CTCs with both markers(E&M-CTCs). CTC detection has clinical implications in the diagnosis of lung cancer(LC).AIM To clarify the diagnostic value of CTCs categorized by EMT markers in LC.METHODS The study included 106 patients with lung adenocarcinoma, including 42 groundglass opacities(GGO) and 64 solid lesions, who underwent surgery between July 2015 and December 2019. Eleven patients with benign tumors and seventeen healthy controls were included. CTCs in peripheral blood and associated EMT markers were detected preoperatively using the CanPatrol TM technique. The diagnostic power of CTCs for discriminating LC cases from controls was analyzed by the receiver operating characteristic(ROC) curve. The CytoploRare technique was used in 20 cases and 18 controls for validation, and Kappa values were calculated to evaluate consistency between techniques.RESULTS Of the 106 LC cases, 94(89.6%) had at least one CTC. CTCs were detectable in 35(83.3%) of 42 GGO cases. Total CTCs and E&M-CTCs were significantly more frequent in LC cases than in benign or healthy controls. The proportion of MCTCs plus E&M-CTCs increased gradually from healthy controls, to benign controls, to LC cases. The area under the ROC curve of total CTCs and E&M-CTCs was > 0.8 and > 10.75, respectively. The combined sensitivity of total-CTCs and E&M-CTCs was 85.85% for LC patients(80.95% for GGO patients) and the specificity was 78.57%.The Kappa value was 0.415,indicating relative consistency between CanPatrol TM and CytoploRare.CONCLUSION CTC detection is valuable for distinguishing LC from controls,and particularly E&M-CTC detection warrants further study.展开更多
In December 2019 a novel coronavirus,named severe acute respiratory syndrome coronavirus 2 was identified and the disease associated was named coronavirus disease 2019(COVID-19).Fever,cough,myalgia,fatigue associated ...In December 2019 a novel coronavirus,named severe acute respiratory syndrome coronavirus 2 was identified and the disease associated was named coronavirus disease 2019(COVID-19).Fever,cough,myalgia,fatigue associated to dyspnea represent most common clinical symptoms of the disease.The reference standard for diagnosis of severe acute respiratory syndrome coronavirus 2 infection is real time reverse-transcription polymerase chain reaction test applied on respiratory tract specimens.Despite of lower specificity,chest computed tomography(CT),as reported in manifold scientific studies,showed high sensitivity,therefore it may help in the early detection,management and follow-up of COVID-19 pneumonia.Patients affected by COVID-19 pneumonia usually showed on chest CT some typical features,such as:Bilateral ground glass opacities characterized by multilobe involvement with posterior and peripheral distribution;parenchymal consolidations with or without air bronchogram;interlobular septal thickening;crazy paving pattern,represented by interlobular and intralobular septal thickening surrounded by ground-glass opacities;subsegmental pulmonary vessels enlargement(>3 mm).Halo sign,reversed halo sign,cavitation and pleural or pericardial effusion represent some of atypical findings of COVID-19 pneumonia.On the other hand lymphadenopathy’s and bronchiectasis’frequency is unclear,indeed conflicting data emerged in literature.Radiologists play a key role in recognition of high suspicious findings of COVID-19 on chest CT,both typical and atypical ones.Thus,the aim of this review is to illustrate typical and atypical CT findings of COVID-19.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Suspected cases accounted for a large proportion in the early st...BACKGROUND The coronavirus disease 2019(COVID-19)is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Suspected cases accounted for a large proportion in the early stage of the COVID-19 outbreak.The deviation of the nucleic acid test by throat swab(the current gold standard of COVID-19)caused by variation in sampling techniques and reagent kits and coupled with nonspecific clinical manifestations make confirmation of the suspected cases difficult.Proper management of the suspected cases of COVID-19 is crucial for disease control.CASE SUMMARY A 65-year-old male presented with fever,lymphopenia,and chest computed tomography(CT)images similar to COVID-19 after percutaneous coronary intervention.The patient was diagnosed as having bacterial pneumonia with cardiogenic pulmonary edema instead of COVID-19.This was based on four negative results for throat swab detection of SARS-CoV-2 nucleic acid using reverse transcriptase-polymerase chain reaction assay and one negative result for serological antibody of SARS-CoV-2 with the serological assay.Additionally,the distribution of ground-glass opacities and thickened blood vessels from the CT images differed from COVID-19 features,which further supported the exclusion of COVID-19.CONCLUSION Distinguishing COVID-19 patients from those with bacterial pneumonia with cardiogenic pulmonary edema can be difficult.Therefore,it requires serious identification.展开更多
AIM:To evaluate the graft rejection and visual outcomes after penetrating keratoplasty(PK)in the presence of various congenital corneal opacities in children.METHODS:In this retrospective cohort study,children who und...AIM:To evaluate the graft rejection and visual outcomes after penetrating keratoplasty(PK)in the presence of various congenital corneal opacities in children.METHODS:In this retrospective cohort study,children who underwent PK were then followed for 5 y.The patient’s medical records were collected from June 2014 until June 2019 and analyzed in December 2019.All patients were children under three years old with congenital corneal opacities with or without microcornea who came to a pediatric ophthalmologist and underwent PK in Jakarta Eye Center(JEC).Beforehand,all children have participated in a thorough evaluation for PK.In the case of severe microcornea was not advised to undergo surgery.The visual outcomes and graft survival rate were described in percentages.The graft survival plot was presented with Kaplan-Meier,while the visual acuity was analyzed using the Wilcoxon signed ranks test.RESULTS:Sixteen eyes from eleven patients(seven girls and four boys)underwent PK.The graft survival rate of the first 6,12,and 18 mo later of keratoplasty was 100%,83.3%,and 66.7%,respectively.The overall mean survival time is 22 mo(standard error 2.419),and no significant difference between the patients underwent PK before and after 36 mo of their age(P=0.52).The graft failure was 50%,and postsurgery complications included cataract 43.7%,band keratopathy 12.5%,and scleromalasia 6.25%.Wilcoxon test analysis of visual acuity post keratoplasty was not statistically significant(P=0.34),while overall showed 44%improvements of visual outcome for 5 y of follow-up.With a good survival at one year up to 22 mo(83.3%),the visual acuity could be achieved(63%),and showed improvements(44%)during follow-up.CONCLUSION:The complications are frequent for pediatric PK.Thus,corneal surgery on infants requires careful case selection,adequate pre-operative evaluation,skilled surgery(optical correction),very close cooperation family–physician,intensive post-operation care,and amblyopia management in the future.展开更多
Objective:To describe the clinical features,proportion of lipid-laden alveolar macrophages in bronchoalveolar lavage(BAL),and short-term and 6-month to 12-month outcomes of patients with Electronic cigarette/Vaping pr...Objective:To describe the clinical features,proportion of lipid-laden alveolar macrophages in bronchoalveolar lavage(BAL),and short-term and 6-month to 12-month outcomes of patients with Electronic cigarette/Vaping product use-Associated Lung Injury(EVALI).Methods:Retrospective review of clinical characteristics,radiographs,and BAL samples for all patients with a history of vaping who presented with acute hypoxemic respiratory failure to the University Hospital in San Antonio,Texas from 9/2019 to 6/2020 was performed.Results:We report 16 cases(15 men;median age,30 years[range 19-75])of EVALI with a history of vaping Tetrahydrocannabinol(THC),nicotine,or both.The most common presenting symptoms were tachycardia,dyspnea,cough,and fever.All patients required supplemental oxygen,including two who required noninvasive positive pressure ventilation,and five who required mechanical ventilation.All 16 patients had bilateral ground-glass opacities(GGO)with peripheral sparing on chest computerized tomography(CT).Cultures were negative,except for one patient who tested positive for rhinovirus.COVID-19 PCR was done in one individual which was negative.Cytology demonstrated lipid-laden macrophages on Oil-Red-O stain on fresh(i.e.,without fixative)BAL in the majority of patients(N=12)with a mean lipid-saturation percentage of 78%[range,44%-100%]and the mean Colombo count of 194[range,101-359].Fifteen patients were treated with systemic corticosteroids.The median length of hospital stay was 10 days.At discharge,three patients required supplemental oxygen.Eight of those who had follow-up imaging showed resolution of GGO.One patient had a relapse of symptoms and was again treated with systemic corticosteroids and mycophenolate,with resolution of symptoms.Fourteen patients who were evaluated after discharge denied vaping post-discharge(two patients were not able to be contacted and did not keep follow-up appointments).Conclusions:Successful diagnosis and management of EVALI requires a high clinical suspicion,thorough evaluation to展开更多
Novel coronavirus(2019-nCoV),also known as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),is a pathogen that has caused a rapidly spreading pandemic all over the world.The primary mean of transmission is ...Novel coronavirus(2019-nCoV),also known as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),is a pathogen that has caused a rapidly spreading pandemic all over the world.The primary mean of transmission is inhalation with a predilection for respiratory system involvement,especially in the distal airways.The disease that arises from this novel coronavirus is named coronavirus disease 2019(COVID-19).COVID-19 may have a rapid and devastating course in some cases leading to severe complications and death.Radiological imaging methods have an invaluable role in diagnosis,follow-up,and treatment.In this review,radiological imaging findings of COVID-19 have been systematically reviewed based on the published literature so far.Radiologic reporting templates are also emphasized from a different point of view,considering specific distinctive patterns of involvement.展开更多
基金Supported by the Natural Science Foundation of Liaoning Province,China(No.2014021009)
文摘AIM： To investigate the prevalence of and risk factors for lens opacities in populations living at two different altitudes in China.·METHODS： A total of 813 subjects aged ≥40y in Lhasa（Tibet Autonomous Region, China. Altitude： 3658 m） and Shaoxing（Zhejiang Province, China. Altitude： 15 m） were underwent eye examinations and interviewed in this cross-sectional study. Participants＇ lens opacities were graded according to the Lens Opacities Classification System II（LOCS II） and the types of opacities with LOCS II scores ≥2 were determined. Univariate and stepwise logistic regression were used to evaluate the associations of independent risk factors with lens opacities.· RESULTS： Lens opacities were significantly more prevalent in the high-altitude than in the low-altitude area（χ2=10.54, P 〈0.001）. Lens opacities appear to develop earlier in people living at high than at low altitude. The main types of lens opacity in Lhasa and Shaoxing were mixed（23.81%） and cortical（17.87%）,respectively. Independent risk factors associated with all lens opacities were age, ultraviolet（UV） radiation exposure,and educational level. Compared with participants aged40-49 y, the risk of lens opacities increased gradually from 2 to 85 times per 10 y [odds ratio（OR）=2.168-84.731,P 〈0.05）. The risk of lens opacities was about two times greater in participants with the highest UV exposure than in those with the lowest exposure（OR=2.606, P =0.001）.Educational level was inversely associated with lensopacities; literacy deceased the risk by about 25%compared with illiteracy（OR=0.758, P =0.041）.·CONCLUSION： Old age, higher UV exposure and lower educational level are important risk factors for the development of lens opacities. Lens opacities are more prevalent among high-altitude than low-altitude inhabitants.
文摘Background Contrast sensitivity （CS） testing can detect differences in functional vision and is highly correlated with visual performance. This study was designed to investigate the association between CS and the grading score using the lens opacities classification system （LOCS） III as well as the association between CS and visual acuity （VA） in nuclear or cortical age-related cataract （ARC） patients. Methods A total of 270 eyes with ARC and 30 control eyes were divided into nuclear opacity （NO）, nuclear color （NC）, cortical cataract （C） based on LOCS II1. The CS values measured at all spatial frequencies under photopic and glare conditions that resulted in contrast sensitivity function （CSF） were evaluated, and LogMAR VA was tested with the Early Treatment Diabetic Retinopathy Study （ETDRS） chart. The correlation between CSF and LOCS III grading scores, and between CSF and LogMAR VA were analyzed. Results Compared to the controls, CSF of the nuclear or cortical ARC significantly declined. There are significant correlation between CSF and LogMAR VA, and between CSF and LOCS III grading scores. Compared to the VA, a stronger correlation existed between CSF and LOCS III grading score than that of LogMAR VA and LOCS III grading score. CS at some spatial frequencies is significantly influenced with LOCS III grading score. Conclusions CSF significantly declined with the increasing ARC grading scores. Comparing to VA, CSF reflected the severity of cataract more comprehensively. CS at low spatial frequency is significantly influenced by ARC. Therefore, CS is more precise than VA in assessing the visual function of ARC patients.
文摘The study was conducted to determine the role of radiological investigation in assessing the severity of COVID-19 pneumonia with the help of chest X-ray (CXR), high resolution computed tomography (HRCT), and ultrasound. This was a retrospective study conducted on 105 COVID-19 patients with symptoms of fever, cough, dyspnea, loss of sense of smell and taste, body ache. Diagnostic tests PCR were positive for COVID-19 included from Medicare Cardiac and General Hospital and Jinnah Medical College Hospital Korangi (JMCH) from April to November 2020. Written informed consent was taken from all participants. This study was approved by ethical review committee, Jinnah Medical & Dental College. Real time-PCR (RT-PCR) was done for the confirmation. Radiological imaging including Chest X-ray, HRCT chest, and ultrasound was done to study the severity of symptoms. Sixty-five patients had mild to moderate symptoms with oxygen saturation between 96% - 98% and 30 patients with severe pneumonia had between saturation 50% - 55%. Patients with mild symptoms were followed up by chest X-ray showing mostly normal chest X-rays but single or patches of ground glass opacities (HRCT). HRCT of 10 patients with low oxygen saturation 50% were already done showing bilateral peripheral patchy consolidation predominantly involving mid and lower lobes. 3 patients presented with patchy lung opacities and ultrasound showing similar findings with pleural effusion and ascites. Radiological imaging, specially CT-Scan was highly significant for diagnosing COVID-19 and severity of infection even in patients with negative PCR. Chest X-ray and ultrasound were also found to be a very useful tool.
文摘Purpose: Age-related lens opacity is the main cause of vision disablitity in elderly population all over the world. This study was designed to investigate the prevalence and incidence of lens opacity.Methods: 1817 eyes of 932 adults over 45 year-old were sampled randomly from 4 villeges within Doumen, a county located in the south of Guangdong provience, China. The procedure of the examination was performed by ophthalmologists. The lens opacities were graded according to a standarized photo of the Lens Opacities Classification System II (LOGS- II ).Results: The prevalence of lens opacities in nuclear color, nuclear opacity, cortical opacity and subcapsular opacity was 16. 1% , 28.,6% , 30. 3% and 8. 7% , respectively. The frequency of all four types of opacities increased with age. The prevalence of lens opacities in four types was higher in female than that in male. Conclusion: The data we got are important for prevalence of lens opacities of population-based study as well as basic information for
文摘Pneumonia is a common complication in organ transplantation patients. Multiple respiratory pathogens such as bacteria, viruses and fungi are potentially coexisted. A 60-year-old male with left eye post corneal transplantation developed acute severe pneumonia caused by <em>Pneumocystis jiroveci</em> (PJP) coinfection with <em>Nocardia spp</em>. and <em>Cytomegalovirus</em> (CMV). He was hospitalized due to acute respiratory failure. Chest radiographs and chest Computed Tomography (CT) revealed extensive ground-glass opacities. PJP was diagnosed from Bronchoalveolar Lavage Fluid (BALF). The pneumonia was persistent despite of receiving intravenous cotrimoxazole. Tracheal aspirate showed faint gram-positive filamentous beaded branching organisms. Consequently <em>Nocardia spp</em>. was proven. Intravenous cotrimoxazole was continued and intravenous imipenem was added. After a course of dual antibiotics, pneumonia was gradually improved. A week after, he developed the worsened acute respiratory failure. The bronchoscopy was performed. The new pathogens were not detected from BALF microbiology. The BALF cytology was unremarkable. PJP was detected by Polymerase Chain Reaction (PCR) from BALF. CMV antigenemia was detected from BALF and blood. Intravenous ganciclovir was given. This report describes PJP coinfected with <em>Nocardia spp</em>. and CMV in post corneal transplantation patient suffering from severe pneumonia. Multiple respiratory pathogens are common among transplantation patients representing host immunosuppression and inadequate antimicorbial prophylaxis.
基金Project supported by the National Key Research and Development Program of China(Grant No.2017YFA0402300)the National Natural Science Foundation of China(Grant Nos.11934004,11404180,and 11604052)the China Postdoctoral Science Foundation(Grant No.2018M631404).
文摘The X^3Σg^-,A^'3△u,A^3Σ^u+,1^3Πg,and B^3Σu^-electronic states of oxygen molecule(O2)are calculated by the multiconfiguration self-consisted filed(MRCI)+Q method with the scalar relativistic correction and core-valence correlation correction.The obtained spectroscopic constants of the low-lying bound states are in excellent agreement with measurements.Based on the accurately calculated structure parameters,the opacities of the oxygen molecule at the temperatures of 1000 K,2000 K,2500 K,and 5000 K under a pressure of 100 atm(1 atm=1.01325×10^5 Pa)and the partition functions between 10 K and 10^4 K are obtained.It is found that with the increase of temperature,the opacities for transitions in a long wavelength range are enlarged because of the larger population on excited electronic states at the higher temperatures.
基金National Natural Science Foundation of China,No.81572285The Natural Science Foundation of Chongqing City,No.cstc2018jcyjAX0592The Army Medical University Clinical Medical Research Talent Training Program,No.2018XLC3062.
文摘BACKGROUND Circulating tumor cells(CTCs) can be clustered into three subtypes according to epithelial-mesenchymal transition(EMT) markers: CTCs with epithelial markers(E-CTCs), CTCs with mesenchymal markers(M-CTCs), and CTCs with both markers(E&M-CTCs). CTC detection has clinical implications in the diagnosis of lung cancer(LC).AIM To clarify the diagnostic value of CTCs categorized by EMT markers in LC.METHODS The study included 106 patients with lung adenocarcinoma, including 42 groundglass opacities(GGO) and 64 solid lesions, who underwent surgery between July 2015 and December 2019. Eleven patients with benign tumors and seventeen healthy controls were included. CTCs in peripheral blood and associated EMT markers were detected preoperatively using the CanPatrol TM technique. The diagnostic power of CTCs for discriminating LC cases from controls was analyzed by the receiver operating characteristic(ROC) curve. The CytoploRare technique was used in 20 cases and 18 controls for validation, and Kappa values were calculated to evaluate consistency between techniques.RESULTS Of the 106 LC cases, 94(89.6%) had at least one CTC. CTCs were detectable in 35(83.3%) of 42 GGO cases. Total CTCs and E&M-CTCs were significantly more frequent in LC cases than in benign or healthy controls. The proportion of MCTCs plus E&M-CTCs increased gradually from healthy controls, to benign controls, to LC cases. The area under the ROC curve of total CTCs and E&M-CTCs was > 0.8 and > 10.75, respectively. The combined sensitivity of total-CTCs and E&M-CTCs was 85.85% for LC patients(80.95% for GGO patients) and the specificity was 78.57%.The Kappa value was 0.415,indicating relative consistency between CanPatrol TM and CytoploRare.CONCLUSION CTC detection is valuable for distinguishing LC from controls,and particularly E&M-CTC detection warrants further study.
文摘In December 2019 a novel coronavirus,named severe acute respiratory syndrome coronavirus 2 was identified and the disease associated was named coronavirus disease 2019(COVID-19).Fever,cough,myalgia,fatigue associated to dyspnea represent most common clinical symptoms of the disease.The reference standard for diagnosis of severe acute respiratory syndrome coronavirus 2 infection is real time reverse-transcription polymerase chain reaction test applied on respiratory tract specimens.Despite of lower specificity,chest computed tomography(CT),as reported in manifold scientific studies,showed high sensitivity,therefore it may help in the early detection,management and follow-up of COVID-19 pneumonia.Patients affected by COVID-19 pneumonia usually showed on chest CT some typical features,such as:Bilateral ground glass opacities characterized by multilobe involvement with posterior and peripheral distribution;parenchymal consolidations with or without air bronchogram;interlobular septal thickening;crazy paving pattern,represented by interlobular and intralobular septal thickening surrounded by ground-glass opacities;subsegmental pulmonary vessels enlargement(>3 mm).Halo sign,reversed halo sign,cavitation and pleural or pericardial effusion represent some of atypical findings of COVID-19 pneumonia.On the other hand lymphadenopathy’s and bronchiectasis’frequency is unclear,indeed conflicting data emerged in literature.Radiologists play a key role in recognition of high suspicious findings of COVID-19 on chest CT,both typical and atypical ones.Thus,the aim of this review is to illustrate typical and atypical CT findings of COVID-19.
基金Supported by Guangdong Provincial Novel Coronavirus Scientific and Technological Project,No.2020111107001.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Suspected cases accounted for a large proportion in the early stage of the COVID-19 outbreak.The deviation of the nucleic acid test by throat swab(the current gold standard of COVID-19)caused by variation in sampling techniques and reagent kits and coupled with nonspecific clinical manifestations make confirmation of the suspected cases difficult.Proper management of the suspected cases of COVID-19 is crucial for disease control.CASE SUMMARY A 65-year-old male presented with fever,lymphopenia,and chest computed tomography(CT)images similar to COVID-19 after percutaneous coronary intervention.The patient was diagnosed as having bacterial pneumonia with cardiogenic pulmonary edema instead of COVID-19.This was based on four negative results for throat swab detection of SARS-CoV-2 nucleic acid using reverse transcriptase-polymerase chain reaction assay and one negative result for serological antibody of SARS-CoV-2 with the serological assay.Additionally,the distribution of ground-glass opacities and thickened blood vessels from the CT images differed from COVID-19 features,which further supported the exclusion of COVID-19.CONCLUSION Distinguishing COVID-19 patients from those with bacterial pneumonia with cardiogenic pulmonary edema can be difficult.Therefore,it requires serious identification.
文摘AIM:To evaluate the graft rejection and visual outcomes after penetrating keratoplasty(PK)in the presence of various congenital corneal opacities in children.METHODS:In this retrospective cohort study,children who underwent PK were then followed for 5 y.The patient’s medical records were collected from June 2014 until June 2019 and analyzed in December 2019.All patients were children under three years old with congenital corneal opacities with or without microcornea who came to a pediatric ophthalmologist and underwent PK in Jakarta Eye Center(JEC).Beforehand,all children have participated in a thorough evaluation for PK.In the case of severe microcornea was not advised to undergo surgery.The visual outcomes and graft survival rate were described in percentages.The graft survival plot was presented with Kaplan-Meier,while the visual acuity was analyzed using the Wilcoxon signed ranks test.RESULTS:Sixteen eyes from eleven patients(seven girls and four boys)underwent PK.The graft survival rate of the first 6,12,and 18 mo later of keratoplasty was 100%,83.3%,and 66.7%,respectively.The overall mean survival time is 22 mo(standard error 2.419),and no significant difference between the patients underwent PK before and after 36 mo of their age(P=0.52).The graft failure was 50%,and postsurgery complications included cataract 43.7%,band keratopathy 12.5%,and scleromalasia 6.25%.Wilcoxon test analysis of visual acuity post keratoplasty was not statistically significant(P=0.34),while overall showed 44%improvements of visual outcome for 5 y of follow-up.With a good survival at one year up to 22 mo(83.3%),the visual acuity could be achieved(63%),and showed improvements(44%)during follow-up.CONCLUSION:The complications are frequent for pediatric PK.Thus,corneal surgery on infants requires careful case selection,adequate pre-operative evaluation,skilled surgery(optical correction),very close cooperation family–physician,intensive post-operation care,and amblyopia management in the future.
文摘Objective:To describe the clinical features,proportion of lipid-laden alveolar macrophages in bronchoalveolar lavage(BAL),and short-term and 6-month to 12-month outcomes of patients with Electronic cigarette/Vaping product use-Associated Lung Injury(EVALI).Methods:Retrospective review of clinical characteristics,radiographs,and BAL samples for all patients with a history of vaping who presented with acute hypoxemic respiratory failure to the University Hospital in San Antonio,Texas from 9/2019 to 6/2020 was performed.Results:We report 16 cases(15 men;median age,30 years[range 19-75])of EVALI with a history of vaping Tetrahydrocannabinol(THC),nicotine,or both.The most common presenting symptoms were tachycardia,dyspnea,cough,and fever.All patients required supplemental oxygen,including two who required noninvasive positive pressure ventilation,and five who required mechanical ventilation.All 16 patients had bilateral ground-glass opacities(GGO)with peripheral sparing on chest computerized tomography(CT).Cultures were negative,except for one patient who tested positive for rhinovirus.COVID-19 PCR was done in one individual which was negative.Cytology demonstrated lipid-laden macrophages on Oil-Red-O stain on fresh(i.e.,without fixative)BAL in the majority of patients(N=12)with a mean lipid-saturation percentage of 78%[range,44%-100%]and the mean Colombo count of 194[range,101-359].Fifteen patients were treated with systemic corticosteroids.The median length of hospital stay was 10 days.At discharge,three patients required supplemental oxygen.Eight of those who had follow-up imaging showed resolution of GGO.One patient had a relapse of symptoms and was again treated with systemic corticosteroids and mycophenolate,with resolution of symptoms.Fourteen patients who were evaluated after discharge denied vaping post-discharge(two patients were not able to be contacted and did not keep follow-up appointments).Conclusions:Successful diagnosis and management of EVALI requires a high clinical suspicion,thorough evaluation to
文摘Novel coronavirus(2019-nCoV),also known as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),is a pathogen that has caused a rapidly spreading pandemic all over the world.The primary mean of transmission is inhalation with a predilection for respiratory system involvement,especially in the distal airways.The disease that arises from this novel coronavirus is named coronavirus disease 2019(COVID-19).COVID-19 may have a rapid and devastating course in some cases leading to severe complications and death.Radiological imaging methods have an invaluable role in diagnosis,follow-up,and treatment.In this review,radiological imaging findings of COVID-19 have been systematically reviewed based on the published literature so far.Radiologic reporting templates are also emphasized from a different point of view,considering specific distinctive patterns of involvement.
