Molecular characterization of Echinococcus granulosus in south-eastern Romania: evidence of G1–G3 and G6–G10 complexes in humans

Echinococcus granulosus is the aetiological agent of cystic echinococcosis (CE), which is a public health problem in many eastern European countries, particularly in Romania, where the infection causes a high number of human and animal cases. To shed light on the transmission patterns of the parasite, we performed a genotyping analysis on 60 cyst samples obtained from patients who live in south-eastern Romania and who underwent surgery for liver or lung CE. DNA was extracted from the endocysts or the cyst fluids, and fragments of cytochrome c oxidase subunit 1 and NADH dehydrogenase subunit 1 mitochondrial genes (cox1 and nd1, respectively) were amplified by PCR and sequenced. We found that most of the samples analysed (59/60) belonged to the G1–G3 complex (E. granulosus sensu stricto), which contains the most widespread and infective strains of the parasite. We also identified the first human patient infected by a non-G1–G3 genotype of E. granulosus in this country. As the DNA sequence of this cyst sample showed maximum homology with the G6–G10 complex (Echinococcus canadensis), this is, in all likelihood, a G7 genotype, which is often found in pigs and dogs in most countries of eastern and south-eastern Europe.     

Hcy、NSE及IL-8水平变化与脑卒中患者神经功能恢复的关系研究

目的分析半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)及白介素-8(IL-8)水平变化与脑卒中患者神经功能恢复的关系。方法选取2017年4月至2019年4月本科室收治的116例缺血性脑卒中急性期后康复患者作为研究组,根据急性期神经功能缺损程度,以及稳定期Brunnstrom分期和ADL指数另分为三个亚组:轻度依赖组46例,中度依赖组40例,重度依赖组30例。同时纳入同期本院健康体检正常者108例作为对照组。比较研究组与对照组Hcy、NSE及IL-8水平差异及Hcy、NSE及IL-8水平在神经功能缺损评分中的表达情况。绘制散点图,采用Pearson相关分析分别观察脑卒中患者Hcy、NSE及IL-8水平与神经功能评分的关系。结果研究组患者Hcy、NSE、IL-8水平显著高于对照组,差异具有统计学意义(P<0.05);不同神经缺损患者血清Hcy、NSE、IL-8水平:重度依赖组>中度依赖组>轻度依赖组,差异有统计学意义(P<0.05);脑卒中患者Hcy、NSE及IL-8与NIHSS评分呈正相关,与Brunnstrom分期和ADL指数呈负相关(P<0.05)。结论 Hcy、NSE及IL-8水平对脑卒中患者神经功能及康复指标具有重要意义,临床工作者可通过加强监测这三项指标,评估疾病进展与预后情况。     

Magnitude of Impact,Overall and on Subspecialties,of Transitioning in Radiology from ICD-9 to ICD-10 Codes

PurposeConverting the nation’s International Classification of Diseases (ICD) diagnosis coding system, from 14,025 ICD-9 to 69,823 ICD-10 codes, is projected to have enormous financial and operational implications. We aimed to assess the magnitude of impact that this code conversion will have on radiology claims.MethodsThe most frequently billed ICD-9 diagnosis codes for 588,523 radiology claims from five hospitals and affiliated outpatient sites during a 12-month period were mapped to matching ICD-10 codes using a Medicare-endorsed tool. The code-conversion impact factor was calculated for the entire radiology system, and each individual subspecialty division.ResultsOf all ICD-9 codes, only 3,407 (24.3%) were used to report any primary diagnosis. Of all claims, 50% were billed using just 37 (0.3%) primary codes; 75% with 131 (0.5%), and 90% with 348 (2.5%). Those 348 ICD-9 codes mapped onto 2,048 ICD-10 codes (5.9-fold impact), representing just 2.9% of all ICD-10 codes. By subspecialty, the conversion impact factor varied greatly, from 1.1 for breast (11 ICD-9 to 12 ICD-10 codes) to 28.8 for musculoskeletal imaging (146 to 4,199). The community division, reflecting a general practice mix, saw a conversion impact factor of 5.8 (254 to 1,471).ConclusionsFewer than 3% of all ICD-9 and ICD-10 codes are used to report an overwhelming majority of all radiology claims. Although the number of commonly used codes will expand 5.9-fold overall, musculoskeletal imaging will experience a projected 28.8-fold explosion. Radiology practices should target their ICD educational and operational conversion efforts in an evidence-based manner.