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31.
《Pancreatology》2022,22(7):864-870
BackgroundMetagenomic next-generation sequencing (mNGS) is increasingly used for the clinical diagnosis of infectious diseases, but there is a paucity of data regarding the application of mNGS in the early diagnosis of infected pancreatic necrosis (IPN).ObjectiveTo investigate the clinical application value of mNGS in the pathogenic diagnosis of IPN.MethodsForty-two patients with suspected IPN were prospectively and consecutively enrolled from August 2019 to August 2021. Blood samples were collected for mNGS and microbial culture simultaneously during fever (T ≥ 38.5 °C). For patients who had indications of surgical interventions, peri-pancreatic specimens were collected for mNGS and microbial culture simultaneously during the first surgical intervention to confirm IPN. The clinical performance of mNGS and microbial culture were compared.ResultsA total of 21 patients (50.0%) were confirmed to have IPN during hospitalization. The sensitivity of blood mNGS was significantly higher than blood culture (95.2% vs. 23.8%, P < 0.001) in diagnosing IPN. The negative predictive value of blood mNGS was 90.0%. The turnaround time of mNGS was significantly shorter than that of microbial culture [(37.70 ± 1.44) vs. (115.23 ± 8.79) h, P < 0.01] and the average costs of mNGS accounted for 1.7% of the average total cost of hospitalization. The survival analysis demonstrates that the positive blood mNGS result was not associated with increased mortality (P = 0.119).ConclusionsWith more valuable diagnostic performance and shorter turnaround time, clinical mNGS represents a potential step forward in the early diagnosis of IPN. 相似文献
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[摘要] HIV相关淋巴瘤是常见的HIV相关肿瘤之一,在联合抗反转录病毒治疗(combination antiretroviral therapy, cART)出现之前,其治疗效果极差。在cART时代,HIV相关淋巴瘤的基础及临床研究取得了重大进展,这些为挖掘治疗新靶点提供了依据,使优化HIV相关淋巴瘤的诊治成为可能。本文对近年来HIV相关淋巴瘤的诊断和治疗进展进行综述。 相似文献
34.
甲状腺癌是内分泌系统常见的恶性肿瘤之一,其发病率呈逐年上升趋势。甲状腺癌以分化型甲状腺癌(differentiated thyroid carcinoma, DTC)为主,尽管多数DTC患者经规范化治疗后预后良好,但由于部分肿瘤的病理类型侵袭性较高或肿瘤组织分化程度较低,病情进展迅速导致患者总生存时间显著缩短。近年来,有关炎症与肿瘤之间相关性的研究越来越多,炎性微环境的改变在肿瘤发病机制中的作用逐渐被证实,更多的证据表明细胞因子可作为肿瘤的良恶性鉴别、预后判断提示及诊疗方案选择等的重要参考依据。本文就部分细胞因子在DTC诊疗中的应用进展进行论述,旨在为DTC的诊疗与预后判断等提供参考依据。 相似文献
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Aleodor A Andea 《Histopathology》2022,80(1):150-165
The work-up of melanocytic tumors has undergone significant changes in the last years following the exponential growth of molecular assays. For the practicing pathologist it is often difficult to sort through the myriad of different tests available currently for clinical use. The molecular tests used in melanocytic pathology can be broadly divided into 4 categories: (i) Tests useful in the differential diagnosis of nevus versus melanoma (primarily used as an aid in the diagnosis of histologically ambiguous melanocytic tumors), (ii) Tests that predict prognosis in melanoma, (iii) Tests useful in the classification of melanocytic tumors and (iv) Tests that predict response to systemic therapy in melanoma. This review will present an updated overview of major ancillary tests used in clinical practice. 相似文献
39.
Qian Huang Xue-Mei Zheng Mao-Lin Zhang Ping Ning Meng-Jun Wu 《World Journal of Clinical Cases》2022,10(31):11252-11259
Although lactation mastitis (LM) has been extensively researched, the incidence rate of LM remains a salient clinical problem. To reduce this incidence rate and achieve a better prognosis, early and specific quantitative indicators are particularly important. It has been found that milk electrolyte concentrations (chloride, potassium, and sodium) and electrical conductivity (EC) significantly change in the early stages of LM in an animal model. Several studies have evaluated EC for the detection of subclinical mastitis in cows. EC, chloride, and sodium content of milk were more accurate for predicting infection status than were other variables. In the early stages of LM, lactic sodium, chloride, and EC increase, but potassium decreases. However, these indicators have not been reported in the diagnosis of LM in humans. This review summarizes the pathogenesis and the mechanism of LM in terms of milk electrolyte concentration and EC, and aim to provide new ideas for the detection of sub-clinical mastitis in humans. 相似文献
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