Medicine
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This study aimed to quantitatively assess the consistency and correlation between perfusion weighted imaging (PWI)/ diffusion weighted imaging (DWI) Alberta Stroke Program Early CT Score (ASPECTS) mismatch and PWI/DWI mismatch. Sixty-eight acute ischemic stroke with middle cerebral artery occlusion who underwent magnetic resonance imaging before thrombectomy were eligible. DWI volume, PWI volume and PWI-DWI mismatch were measured. ⋯ Spearman's rank correlation analysis revealed that PWI-DWI mismatch volume was negatively correlated with PWI-DWI ASPECTS mismatch (r = -0.802; P = .000). Receiver operating characteristic analysis showed that when the PWI-DWI ASPECTS mismatch cut point was ≥ 2, the under curve of PWI-DWI ASPECTS mismatch for predicting PWI-DWI mismatch was 0.954 (95%CI, 0.911-0.998), with the sensitivity and specificity were 84.00% and 100% respectively. PWI-DWI ASPECTS mismatch may represent a convenient surrogate for penumbra in clinical trials.
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Intracerebral hemorrhage (ICH) is the second most common subtype of stroke with higher mortality and morbidity, and it lacks effective prognostic markers. The aim of this research is to construct newly valuable prognostic nomogram incorporating red blood cell distribution width (RDW) for ICH patients. We retrospectively analyzed 953 adult patients with ICH. ⋯ Decision curve analysis showed an increased net benefit for utilizing the nomogram. High RDW values are associated with an unfavorable outcome after ICH. The established nomogram incorporating RDW should be considered for a 30-day functional prognosis.
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Second primary cancer is prevalent in patients with gastrointestinal (GI) cancer, for which lung cancer is the most common and associated with high lethality. Image screening for lung cancer was proved to be effective in early diagnosis and lower mortality. However, trials of screen for lung cancer generally excluded patients with a previous diagnosis of malignancy. ⋯ GI-hepatic cancer was the most common primary malignancy in the lung cancer cohort. Patients had better survival outcome when secondary lung cancer was diagnosed in original primary cancer clinic. Chest image screening strategy may contribute better survival in secondary lung cancer due to detection at an earlier stage.
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Comparative Study Observational Study
A comparative study of four Bowie-Dick test under the condition of pressure steam sterilizer simulating gas leakage.
We aimed to understand the evaluation of different Bowie-Dick test (B-D test) on the performance of pressure steam sterilization equipment in the case of simulated gas leakage, and we selected a pulsating vacuum steam sterilizer to set 4 different gas leakage levels: 1.1, 1.3, 1.5, and 1.7 mbar/min during the B-D test phase. In terms of methods, 4 different brands of B-D test kits (devices) were tested at 4 different leakage rates, and a total of 48 experiments were conducted. The results from univariate analysis revealed that there are statistically significant differences in the judgment of test results among different personnel and brands. ⋯ Result judgments of brand 1 and brand 2 are susceptible to subjective factors. The judgment of brand 3 is intuitive and consistent with the evaluation result of brand 4. In conclusion, the order of capacity to evaluate air leakage from best to worst is brand 4→brand 3→brand 1→brand 2.
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Observational Study
Time to sputum culture conversion and its predictors among patients with multidrug-resistant tuberculosis in Hangzhou, China: A retrospective cohort study.
The objective is to investigate the time to initial sputum culture conversion (SCC) and its predictors among multidrug-resistant tuberculosis (MDR-TB) patients in Hangzhou, China. A retrospective cohort study was conducted among patients who initiated MDR-TB treatment from 2011 to 2015 in Hangzhou, China. Successful achievement of initial SCC was defined as 2 consecutive negative cultures taken at least 30 days apart after initiation of treatment of MDR-TB. ⋯ Multivariate analysis showed that age 25 to 64 years (compared with age<25; adjusted odds ratio [AOR], 0.7; 95% confidence interval [CI], 0.5-0.9; P < .01), age ≥65 years (compared with age < 25; AOR, 0.5; 95% CI, 0.3-0.8; P < .01), and household registration in Hangzhou (compared with non-Hangzhou registration; AOR, 1.3; 95% CI, 1.0-1.5; P < .05) were found to be associated with SCC. Although high SCC and treatment success rates were observed among MDR-TB patients in Hangzhou, the prolonged duration to initial SCC underscores the importance of emphasizing measures for infection control. A new policy of shifting outpatient treatment to inpatient treatment in China may reduce the risk of transmission from patients in the time window prior to SCC.