Objective: To report an unusual case of pyriform sinus-pleural-mediastinal fistula secondary to internal penetrating trauma by a toothbrush, with emphasis on management options. Case report: A 26-year-old woman swallo...Objective: To report an unusual case of pyriform sinus-pleural-mediastinal fistula secondary to internal penetrating trauma by a toothbrush, with emphasis on management options. Case report: A 26-year-old woman swallowed a toothbrush in a violent manner 8 months ago in an attempt of self-mutilation. She immediately complained of neck pain and dysphagia. She was diagnosed with pyriform sinus-pleural-mediastinal fistula. The fistula was repaired. Primary closure was performed and covered with the sternocleidomastoid muscle flap, and reinforced with thyroid tissue and surrounding tissues. The patient did not present any complications or recurrence, and she gained weight after the operation. Conclusion: Early recognition of hypopharyngeal perforation is important, and in selected cases, immediate repair of the perforation can lead to a good prognosis.展开更多
Introduction:A novel recombinant antigen-based capture enzyme immunoassay(RAg-CEIA)was optimized and used to determine technical parameters for estimating human immunodeficiency virus type 1(HIV-1)incidence in China.M...Introduction:A novel recombinant antigen-based capture enzyme immunoassay(RAg-CEIA)was optimized and used to determine technical parameters for estimating human immunodeficiency virus type 1(HIV-1)incidence in China.Methods:We employed orthogonal experimental design to optimize RAg-CEIA by adjusting raw material dilution ratios.The assay was used to measure normalized optical density(ODn)values in 171 longitudinal plasma specimens from 51 HIV-1 seroconverting individuals,plotted against estimated days post-seroconversion.We determined the optimal ODn threshold value for differentiating recent from long-term infections and calculated the mean duration of recent infection(MDRI)for incidence estimation.The false recent rate(FRR)was determined using 481 HIV-1 antibody-positive specimens with infection durations exceeding twice the MDRI.Results:Optimal RAg-CEIA parameters were established with a raw material dilution ratio of 1/12 for calibrator preparation and an enzyme conjugate titer of 1:1200.ODn values demonstrated consistent temporal increases across HIV-1 seroconverting individuals,though with notable kinetic heterogeneity in individual responses.The optimal ODn threshold value of 0.8 for distinguishing recent from long-term infections corresponded to an MDRI of 205 days and an FRR of 4.78%.Conclusions:The optimized RAg-CEIA effectively differentiates recent from long-term HIV-1 infections at the population level,enabling reliable HIV-1 incidence estimation in China.展开更多
文摘Objective: To report an unusual case of pyriform sinus-pleural-mediastinal fistula secondary to internal penetrating trauma by a toothbrush, with emphasis on management options. Case report: A 26-year-old woman swallowed a toothbrush in a violent manner 8 months ago in an attempt of self-mutilation. She immediately complained of neck pain and dysphagia. She was diagnosed with pyriform sinus-pleural-mediastinal fistula. The fistula was repaired. Primary closure was performed and covered with the sternocleidomastoid muscle flap, and reinforced with thyroid tissue and surrounding tissues. The patient did not present any complications or recurrence, and she gained weight after the operation. Conclusion: Early recognition of hypopharyngeal perforation is important, and in selected cases, immediate repair of the perforation can lead to a good prognosis.
基金Supported by the National Science and Technology Major Project of the 13th Five-year Plan(grants 2017ZX10201101-002-003 and 2018ZX10721102-003-002)。
文摘Introduction:A novel recombinant antigen-based capture enzyme immunoassay(RAg-CEIA)was optimized and used to determine technical parameters for estimating human immunodeficiency virus type 1(HIV-1)incidence in China.Methods:We employed orthogonal experimental design to optimize RAg-CEIA by adjusting raw material dilution ratios.The assay was used to measure normalized optical density(ODn)values in 171 longitudinal plasma specimens from 51 HIV-1 seroconverting individuals,plotted against estimated days post-seroconversion.We determined the optimal ODn threshold value for differentiating recent from long-term infections and calculated the mean duration of recent infection(MDRI)for incidence estimation.The false recent rate(FRR)was determined using 481 HIV-1 antibody-positive specimens with infection durations exceeding twice the MDRI.Results:Optimal RAg-CEIA parameters were established with a raw material dilution ratio of 1/12 for calibrator preparation and an enzyme conjugate titer of 1:1200.ODn values demonstrated consistent temporal increases across HIV-1 seroconverting individuals,though with notable kinetic heterogeneity in individual responses.The optimal ODn threshold value of 0.8 for distinguishing recent from long-term infections corresponded to an MDRI of 205 days and an FRR of 4.78%.Conclusions:The optimized RAg-CEIA effectively differentiates recent from long-term HIV-1 infections at the population level,enabling reliable HIV-1 incidence estimation in China.