Antifungal susceptibility testing practices in mycology laboratories in France, 2018

A survey of mycology laboratories for antifungal susceptibility testing (AFST) was undertaken in France in 2018, to better understand the difference in practices between the participating centers and to identify the difficulties they may encounter as well as eventual gaps with published standards and guidelines. The survey captured information from 45 mycology laboratories in France on how they perform AFST (number of strains tested, preferred method, technical and quality aspects, interpretation of the MIC values, reading and interpretation difficulties). Results indicated that 86% of respondents used Etest as AFST method, with a combination of one to seven antifungal agents tested. Most of the participating laboratories used similar technical parameters to perform their AFST method and a large majority used, as recommended, internal and external quality assessments. Almost all the participating mycology laboratories (98%) reported difficulties to interpret the MIC values, especially when no clinical breakpoints are available. The survey highlighted that the current AFST practices in France need homogenization, particularly for MIC reading and interpretation.     

胸腔镜下心包厚壁囊肿切除术1例报告

面对来势汹汹的新型冠状病毒肺炎(COVID-19),如何能够正确、快速诊断和筛检出确诊病例显得尤为重要,国内诸多科技工作者都在积极开展相关的诊断试验研究。本文回顾了目前正在开展的十余项诊断试验的注册信息,针对其中存在的共性问题进行了讨论,重点阐述了如何使用PICOS原则构造COVID-19诊断试验的研究问题,还对金标准的设置、受试者的代表性、样本量计算和同步、独立、盲法的测定等诊断试验的设计要点进行了详细说明。旨在为广大研究者提供开展COVID-19诊断试验的设计建议,帮助研究者在顶层设计阶段减少、避免偏倚,完成高质量的临床研究,为临床诊疗提供循证医学证据。     

An eco-friendly HPLC-UV method for the determination of risedronate in its bulk and tablet dosage form with application to content uniformity,dissolution and stability testing

Risedronate is a nitrogen-containing bisphosphonate for the treatment and prevention of postmenopausal osteoporosis. The current work aims to develop a novel green HPLC-UV method for the rapid analysis of risedronate sodium in bulk and tablet formulation. The analyzed samples were separated on Waters Atlantis dC18 (150 mm × 3.9 mm; 5 μm) column using a green mobile phase consisting of potassium phosphate buffer pH 2.9 and potassium edetate buffer pH 9.5 in a ratio of 1:2, the final pH was adjusted to 6.8 with phosphoric acid, the mobile phase was pumped at a rate of 1.0 mL/min, with column temperature set at 30 °C, eluted samples were detected at 263 nm and the chromatographic run time was 3.0 min. The method was found to be linear over the concentration range of 14–140 μg/mL with a correlation coefficient (r²) of 0.9994. Accuracy and precision were evaluated from three QC samples (LQC, MQC and HQC) together with the five calibrators where the percentage accuracy was found to be 101.84%. Processed quality control samples of risedronate sodium were tested for stability at different conditions, short term, long term and freeze- thaw stability. The current method was further extended to study the content uniformity of Actonel® tablets following United States Pharmacopoeia (USP) guidelines. The proposed method was fully validated as per ICH guidelines.     

Imaging benign gynaecological conditions

Radiology plays an essential role in the management of benign gynaecological conditions and includes: ultrasound; computed tomography and magnetic resonance imaging. Each modality has a different role in diagnosis, treatment selection and follow-up. This review discusses the different imaging modalities, their recommended roles in the imaging and imaging findings of common female pelvic pathology.     

Statistical inference for decision curve analysis,with applications to cataract diagnosis

Statistical learning methods are widely used in medical literature for the purpose of diagnosis or prediction. Conventional accuracy assessment via sensitivity, specificity, and ROC curves does not fully account for clinical utility of a specific model. Decision curve analysis (DCA) becomes a novel complement as it incorporates a clinical judgment of the relative value of benefits (treating a true positive case) and harms (treating a false positive case) associated with prediction models. The preference of a patient or a policy-maker is formulated statistically as the underlying threshold probability, above which the patient would choose to be treated. Net benefit is then calculated for possible threshold probability, which places benefits and harms on the same scale. We consider the inference problems for DCA in this paper. Interval estimation procedure and inference methodology are provided after we derive the relevant asymptotic properties. Our formulation can accommodate the classification problems with multiple categories. We carry out numerical studies to assess the performance of the proposed methods. An eye disease dataset is analyzed to illustrate our proposals.     

布地奈德联合特布他林对慢性阻塞性肺疾病患者肺功能的影响

目的:探究布地奈德与特布他林联合应用于慢性阻塞性肺疾病(COPD)患者中的治疗效果,并探究其对患者肺功能的影响。方法:选取某院2018年4月~2019年3月收治的COPD患者(n=82例)为实验对象,依据不同的治疗方法,将入选患者分为联合组及单一组,每组41例,其中单一组采用特布他林治疗,联合组采用特布他林联合布地奈德治疗。观察两组患者的治疗效果、不良反应及其治疗前后的肺功能改善情况。结果:联合组的治疗总有效率为95.12%,与单一组的75.61%比较,两者差异显著(χ^2=6.248,P<0.05)。联合组治疗后FEV1为(2.46±0.97)L,显著高于单一组[(1.35±0.32)L,P<0.05];FVC为(2.84±0.66)L,显著高于单一组[(2.26±0.15)L,P<0.05];FEV1/FVC为(65.51±8.96),显著高于单一组[(58.31±7.93),P<0.05]。联合组的总不良反应率为7.32%,低于单一组的12.20%,但差异不显著(χ^2=0.554,P>0.05)。结论:布地奈德结合特布他林治疗COPD具有较好的治疗效果,可显著改善患者的肺功能,减少不良反应,安全性高。     

甲状腺手术患者围术期优质护理干预效果探讨

目的观察分析在甲状腺手术患者护理中予以围术期优质护理干预的应用价值。方法此研究从本院甲状腺手术患者中选取样本,总例数为80例,研究时间始于2017年4月,止于2019年4月,依据护理方案的异同对患者进行分组,试验组予以围术期优质护理干预,对照组予以常规性护理干预,对比两组护理结果。结果研究可得,试验组护理满意率相对较高,组间数据对比得知与对照组相比统计值合理(P<0.05)。研究可得,试验组并发症发生率相对较低,组建数据对比得知与对照组相比统计值合理(P<0.05);研究可得,试验组预后生活质量相对较高,组建数据对比得知与对照组相比统计值合理(P<0.05)。结论此研究得知,在甲状腺手术患者护理中予以围术期优质护理干预,能提高患者护理效果,降低其并发症发生情况,并进一步改善患者预后效果。     

中期18F-FDG PET-CT两种图像判读法在弥漫性大B细胞淋巴瘤预后评估中的应用

目的:探讨中期正电子发射型计算机断层显像(positron emission tomography-computed tomography,PET-CT)Deauville五分法(Deauville five-point scale,5-PS)与最大标准摄取值缩减率(maximum standard uptake value variation,△SUVmax)两种图像判读法在弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者预后评估中的应用价值。方法:回顾性分析2012年10月至2018年6月重庆医科大学附属第一医院收治的94例DLBCL患者资料。采用Kaplan-Meier法及Cox比例风险回归模型进行生存资料分析,计算并采用χ2检验比较5-PS和△SUVmax对DLBCL患者预后预测的能力。结果:5-PS和△SUVmax分别以4分、86%进行分组。5-PS<4分组、△SUVmax≥86%组的患者无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS)均优于5-PS≥4分组、△SUVmax<86%组的患者(P<0.05)。△SUVmax与5-PS对患者PFS和OS均有影响,较高的阴性预测值(89.4%,93.6%;76.1%,85.9%),较低的阳性预测值(48.9%,31.9%;47.8%,34.8%),并且△SUVmax对于患者的敏感性优于5-PS(82.1%,83.3%vs.39.3%,44.4%)。单因素分析中国际预后指数(international prognostic index,IPI)(P=0.007)、△SUVmax(P<0.001)、5-PS(P=0.014)及基线全身肿瘤代谢体积(total metabolic tumor volume,TMTV)(P=0.001)与PFS相关,△SUVmax(P=0.014)、5-PS(P=0.033)、TMTV(P=0.004)与OS相关;多因素分析显示TMTV是OS的独立预测因子(P=0.005),△SUVmax和TMTV是PFS的独立预测因子(P=0.002,P=0.020),并且△SUVmax<86%且高水平TMTV患者较低TMTV患者的PFS明显缩短(P=0.001)。结论:5-PS和△SUVmax均能初步评估DLBCL患者预后,但△SUVmax具有更高的预测价值,并且联合基线TMTV可以对DLBCL患者进行再次危险度分层。