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Zhang XH, Zhou C, Luo YM, Ge HQ, Liu HG, Wei HL, Zhang JC, Pan PH, Li XH, Zhou H, Cheng LN, Yi MQ, Zhang JR, Adila A, Peng LG, Liu Y, Pu JQ, Liu L, Feng HP, Zhou HX, Yi Q. [Clinical features and related factors of invasive pulmonary aspergillosis in patients with acute exacerbation of chronic obstructive pulmonary disease]. Zhonghua Yi Xue Za Zhi 2023; 103:1692-1699. [PMID: 37302977 DOI: 10.3760/cma.j.cn112137-20221106-02333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To study the clinical features and related factors of invasive pulmonary aspergillosis (IPA) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: This retrospective study enrolled patients hospitalized for AECOPD in ten tertiary hospitals of China from September 2017 to July 2021. AECOPD patients with IPA were included as case group, AECOPD patients without IPA were randomly selected as control group from the same hospitals and same hospitalization period as the patients with IPA using the random function in the software of Microsoft Excel 2003, at a ratio of 2∶1. The clinical characteristics, treatment and outcome were compared between the two groups. Binary logistic regression model was used to analyze the factors associated with IPA in AECOPD patients. Results: A total of 14 007 inpatients with AECOPD were included in this study, and 300 patients were confirmed to have IPA, with an incidence rate of 2.14%. According to the above matching method, 600 AECOPD patients without aspergillus infection were enrolled as the control group. The age of the case group and the control group were (72.5±9.7) and (73.5±10.3) years old, with 78.0%(n=234) male and 76.8%(n=461) male, respectively. There were no significant differences in age and gender composition between the two groups (all P>0.05). The prognosis of case group was significantly worse than that of the control group, with longer hospital stay [M(Q1,Q3)], [14 (10-20) d vs 11 (8-15) d, P<0.001], higher ICU admission rate [16.3% (49 case) vs 10.0% (60 case), P=0.006], higher in-hospital mortality [4.0% (12 cases) vs 1.3% (8 cases), P=0.011], and higher hospitalization costs (28 000 ¥ vs 13 700 ¥, P<0.001). The smoking index of the case group and proportions of patients with diabetes mellitus, chronic pulmonary heart disease in the case group were significantly higher than those in control group (all P<0.05). In terms of clinical features, the proportions of patients with cough, expectoration, purulent sputum, hemoptysis and fever in the case group were higher than those in the control group, the serum albumin was significantly lower than that in the control group, and the proportions of patients with bronchiectasis and pulmonary bullae on imaging were significantly higher than those in the control group (all P<0.05). Diabetes (OR=1.559, 95%CI: 1.084-2.243), chronic pulmonary heart disease (OR=1.476, 95%CI: 1.075-2.028), bronchiectasis (OR=1.506, 95%CI: 1.092-2.078), pulmonary bullae (OR=1.988, 95%CI: 1.475-2.678) and serum albumin<35 g/L (OR=1.786, 95%CI: 1.325-2.406) were the related factors of IPA in patients with AECOPD. Conclusions: The incidence of IPA in AECOPD patients is relatively high and the prognosis of these patients is worse. Diabetes, chronic pulmonary heart disease, bronchiectasis, pulmonary bulla, hypoproteinemia are the related factors of IPA in patients with AECOPD.
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Affiliation(s)
- X H Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - C Zhou
- West China Medical College of Sichuan University, Chengdu 610041, China
| | - Y M Luo
- State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou 510000, China
| | - H Q Ge
- Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - H G Liu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - H L Wei
- Department of Respiratory and Critical Care Medicine, Leshan People's Hospital of Sichuan Province, Leshan 614000, China
| | - J C Zhang
- Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - P H Pan
- Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410000, China
| | - X H Li
- Department of Respiratory and Critical Care Medicine, Neijiang First People's Hospital, Neijing 641000, China
| | - H Zhou
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - L N Cheng
- Department of Emergency, Jiujiang First People's Hospital, Jiujiang 332000, China
| | - M Q Yi
- Department of Emergency, Jiujiang First People's Hospital, Jiujiang 332000, China
| | - J R Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Aili Adila
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L G Peng
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Y Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - J Q Pu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - H P Feng
- Department of Respiratory and Critical Care Medicine, Chengdu Sixth People's Hospital, Chengdu 610051, China
| | - H X Zhou
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Q Yi
- Sichuan Cancer Hospital, Chengdu 610042, China
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Adila A, Tang YJ, Zhang JR, Liu Y, Peng LG, Pu JQ, Wang MY, Wang L, Zhou HX, Yi Q. [Analysis of the relationship between syncope and poor prognosis in patients with acute pulmonary embolism and related factors]. Zhonghua Yi Xue Za Zhi 2022; 102:1374-1378. [PMID: 35545582 DOI: 10.3760/cma.j.cn112137-20210824-01922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the association between syncope and poor prognosis and related factors of syncope in patients with acute pulmonary embolism (APE). Methods: A total of 740 patients with first diagnosed APE treated in West China Hospital of Sichuan University from September 1, 2016 to December 30, 2019 were enrolled. The basic information and clinical information (including clinical manifestations, complications, auxiliary examination, treatment and prognosis, etc.) of the patients were obtained from inpatient medical records. The patients were divided into the syncope group and the non-syncope group according to whether they had syncope or not. The basic and clinical conditions of the two groups were compared, and the factors related to syncope in APE patients were analyzed by multiple logistic regression model. Results: The proportion of APE patients with syncope was 12.6% (93/740). Age was (59±16) years in the syncope group (93 cases) and (59±17) years in the non-syncope group (647 cases), with 57.0% (53/93) and 60.4% (391/647) males, respectively. The body mass index, in-hospital mortality, proportions with high risk APE and mechanical ventilation of the syncope group were higher than those of the non-syncope group [(24.5±4.0) kg/m2 vs (23.3±3.8) kg/m2, 16.1% vs 7.7%, 4.4% vs 1.3% and 9.7% vs 2.5%, respectively]. The length of hospital stay [M (Q1, Q3)] of the syncope group was longer than that of the non-syncope group [15 (10, 22) d vs 14 (9, 22) d], and the proportions with chest pain and hemoptysis were lower than those of the non-syncope group (19.4% vs 36.8% and 14.0% vs 27.2%, respectively) (all P values<0.05). Multivariate logistic regression analysis showed that enlargement of the right heart [OR (95%CI): 2.46 (1.07, 5.64)] was a factor associated with syncope in APE patients. Conclusion: The proportion of APE patients with syncope is relatively high and is associated with poor prognosis, while enlargement of the right heart is associated with syncope in APE patients.
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Affiliation(s)
- Aili Adila
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Y J Tang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - J R Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Y Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L G Peng
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - J Q Pu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - M Y Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - H X Zhou
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qun Yi
- Leshan Vocational and Technical College, Leshan 613100, China
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Zhu XH, Li XM, Zhang WL, Liao MM, Li Y, Wang FF, Shang B, Peng LG, Su YJ, You ZJ, Shi JY, Zhong WL, Liang XR, Liang CJ, Liang L, Liao WT, Ding YQ. [Application of artificial intelligence-assisted diagnosis for cervical liquid-based thin-layer cytology]. Zhonghua Bing Li Xue Za Zhi 2021; 50:333-338. [PMID: 33831990 DOI: 10.3760/cma.j.cn112151-20201013-00780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the application value of artificial intelligence-assisted diagnosis system for TBS report in cervical cancer screening. Methods: A total of 16 317 clinical samples and related data of cervical liquid-based thin-layer cell smears, which were obtained from July 2020 to September 2020, were collected from Southern Hospital, Guangzhou Huayin Medical Inspection Center, Shenzhen Bao'an People's Hospital(Group) and Changsha Yuan'an Biotechnology Co., Ltd. The TBS report artificial intelligence-assisted diagnosis system of cervical liquid-based thin-layer cytology jointly developed by Southern Medical University and Guangzhou F. Q. PATHOTECH Co., Ltd. based on deep learning convolution neural network was used to diagnose all clinical samples. The sensitivity,specificity and accuracy of both artificial intelligence-assisted diagnosis system and cytologists using artificial intelligence-assisted diagnosis system were analyzed based on the evaluation standard(2014 TBS). The time spent by the two methods was also compared. Results: The sensitivity of artificial intelligence-assisted diagnosis system in predicting cervical intraepithelial lesions and other lesions (including endometrial cells detected in women over 45 years old and infectious lesions) under different production methods, different cytoplasmic staining and different scanning instruments was 92.90% and 83.55% respectively, and the specificity of negative samples was 87.02%, while that of cytologists using artificial intelligence-assisted diagnosis system was 99.34%, 97.79% and 99.10%, respectively. Moreover, cytologists using artificial intelligence-assisted diagnosis system could save about 6 times of reading time than manual. Conclusions: Artificial intelligence-assisted diagnosis system for TBS report of cervical liquid-based thin-layer cytology has the advantages of high sensitivity, high specificity and strong generalization. Cytologists can significantly improve the accuracy and work efficiency of reading smears by using artificial intelligence-assisted diagnosis system.
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Affiliation(s)
- X H Zhu
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou 510515, China
| | - X M Li
- Department of Pathology, Shenzhen Bao'an People's Hospital(Group), Shenzhen 518101, China
| | - W L Zhang
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou 510515, China
| | - M M Liao
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou 510515, China
| | - Y Li
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou 510515, China
| | - F F Wang
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou 510515, China
| | - B Shang
- Guangzhou F. Q. PATHOTECH Co., Ltd, Guangzhou 510515, China
| | - L G Peng
- Guangzhou F. Q. PATHOTECH Co., Ltd, Guangzhou 510515, China
| | - Y J Su
- Guangzhou F. Q. PATHOTECH Co., Ltd, Guangzhou 510515, China
| | - Z J You
- Guangzhou F. Q. PATHOTECH Co., Ltd, Guangzhou 510515, China
| | - J Y Shi
- Guangzhou F. Q. PATHOTECH Co., Ltd, Guangzhou 510515, China
| | - W L Zhong
- Guangzhou Huayin Medical Inspection Center, Guangzhou 510515, China
| | - X R Liang
- Guangzhou Huayin Medical Inspection Center, Guangzhou 510515, China
| | - C J Liang
- Changsha Yuan'an Biotechnology Co., Ltd, Changsha 410000, China
| | - L Liang
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou 510515, China
| | - W T Liao
- Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou 510060, China
| | - Y Q Ding
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou 510515, China
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Yang L, Yu W, Yan WL, Peng LG. 116 EXPRESSION OF INSULIN-LIKE GROWTH FACTOR 2 RECEPTOR (IGF2R), LEPTIN RECEPTOR (LEPR) AND SERUM- AND GLUCOCORTICOID-REGULATED KINASE 1 (SGK1) mRNA IN HUMAN AND BOVINE PREGNANCIES. Reprod Fertil Dev 2013. [DOI: 10.1071/rdv25n1ab116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The objective was to investigate the expression of insulin-like growth factor 2 receptor (IGF2R), leptin receptor (LEPR), and serum- and glucocorticoid-regulated kinase 1 (SGK1) mRNA in human decidua and bovine pregnancies. The IGF2R, LEPR, and SGK1 mRNA were measured by using quantitative real-time PCR in 25 patients with spontaneous abortion, 23 early pregnancy decidua from patients that underwent elective abortion, 8 cloned bovine pregnancies, and 2 normal bovine pregnancies. The expression of LEPR and SGK1 in the human spontaneous abortion group was lower than the early pregnancy (elective abortion) group (P < 0.05) but the expression of IGF2R was increased in the spontaneous abortion group (P < 0.05). The expression of IGF2R, LEPR, and SGK1 mRNA was decreased in the cloned bovine pregnancy group (P < 0.05). Reduced expression of LEPR and SGK1 mRNA in human pregnancies undergoing spontaneous abortion indicates the key role for these transcripts in spontaneous abortion. Low expression of IGF2R, LEPR, and SGK1 in cloned bovine pregnancies may affect endometrial receptivity and contribute to high spontaneous abortion rate in cloned cattle.
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