Background: Tuberculosis (TB) diagnostics, such as Xpert MTB/RIF, is still limited by cost. Testing of pooled samples from presumptive TB patients has been thought as a cost-saving strategy to diagnose TB. We assessed...Background: Tuberculosis (TB) diagnostics, such as Xpert MTB/RIF, is still limited by cost. Testing of pooled samples from presumptive TB patients has been thought as a cost-saving strategy to diagnose TB. We assessed the utility and cost-saving of pooled Xpert MTB/RIF testing strategy for the diagnosis of TB in Mwanza, Tanzania. Methods: Sputum samples from Presumptive TB patients were submitted to TB laboratory for routine diagnosis of TB using Xpert MTB/RIF. The TB results from the individual sputum samples were used as the reference standard and were concealed to the investigating laboratory technicians. The remainder of samples were collected serially and were pooled (5 samples per pool) for testing. The agreement of the results between individual sample testing against pooled sample testing and cost-savings was assessed. Results: A total of 250 sputum samples from presumptive TB patients were analyzed and 50 pools were made with each pool containing 5 samples. Of the 50 sputum pools made, Mycobacterium tuberculosis (MTB) was detected in 17 (34.0%) pools. Results from the individual sputum samples MTB/RIF testing were retrieved for all 250 samples and there were 28 (11.2%) samples in which MTB was detected whereas 222 (88.8%) samples had no MTB detected. Following re-analysis of positive pools, all 28 (100%) individual positive MTB samples were detected within the 17 positive pools, with 1 to 3 individual MTB positive samples per pool. The individual sputum samples were correctly identified by pooled sputum on Xpert MTB/RIF testing, with the sensitivity of 100% and specificity of 100%. Using pooling of sputum samples strategy, we saved 46.0% (115/250) of the cartridges. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0% and has the potential to increase the affordability of Xpert MTB/RIF testing in countries with limited resources, such as Tanzania.展开更多
<strong>Background: </strong>The incidence of cervical, thoracic and lumbar spinal canal stenosis is low. It is difficult to identify the main focus and responsible segment, and it is also difficult to sel...<strong>Background: </strong>The incidence of cervical, thoracic and lumbar spinal canal stenosis is low. It is difficult to identify the main focus and responsible segment, and it is also difficult to select the sequence of staging surgery. We report a patient with triple stenosis. <strong>Case Presentation:</strong> In this paper, we introduced a 61-year-old female patient with cervical, thoracic and lumbar spinal canal stenosis who had previously undergone “lumbar discectomy” in the outer hospital. The postoperative effect was not good and the symptoms were poor. The diagnosis was “cervical spinal stenosis and lumbar postoperative surgery”. The staged spinal canal decompression operation and Duhuo Jisheng Decoction (DHJSD) treatment were conducted in our hospital. After three months of follow-up, the functional and imaging results were satisfactory. <strong>Conclusions:</strong> The main focus and responsible spinal segment should be determined by the comprehensive analysis of medical history, signs, and images. Surgery combined with Chinese herbal medicine DHJSD therapy may be an effective treatment for this kind of disease.展开更多
The present study was designed to characterize the chemical constituents of Guge Fengtong Tablet(GGFTT).Based on the chromatographic retention behavior,fragmentation pathways of chemical components and the published l...The present study was designed to characterize the chemical constituents of Guge Fengtong Tablet(GGFTT).Based on the chromatographic retention behavior,fragmentation pathways of chemical components and the published literatures,a diagnostic ion filtering strategy with electrospray ionization quadrupole time-of-flight tandem mass spectrometry(HPLC-ESI-Q-TOF/MS) was established to identify the multiple bioactive constituents of GGFTT.The rapid identification of forty-seven components,including 18 phenolic acids,8 saponins,14 gingerol-related compounds,and 7 diarylhepatonoids,was accomplished using this newly developed method.The coupling of HPLC-ESI-Q-TOF/MS with the diagnostic ion filtering strategy was useful and efficient for the in-depth structural elucidation of chemical compounds of GGFTT.展开更多
文摘Background: Tuberculosis (TB) diagnostics, such as Xpert MTB/RIF, is still limited by cost. Testing of pooled samples from presumptive TB patients has been thought as a cost-saving strategy to diagnose TB. We assessed the utility and cost-saving of pooled Xpert MTB/RIF testing strategy for the diagnosis of TB in Mwanza, Tanzania. Methods: Sputum samples from Presumptive TB patients were submitted to TB laboratory for routine diagnosis of TB using Xpert MTB/RIF. The TB results from the individual sputum samples were used as the reference standard and were concealed to the investigating laboratory technicians. The remainder of samples were collected serially and were pooled (5 samples per pool) for testing. The agreement of the results between individual sample testing against pooled sample testing and cost-savings was assessed. Results: A total of 250 sputum samples from presumptive TB patients were analyzed and 50 pools were made with each pool containing 5 samples. Of the 50 sputum pools made, Mycobacterium tuberculosis (MTB) was detected in 17 (34.0%) pools. Results from the individual sputum samples MTB/RIF testing were retrieved for all 250 samples and there were 28 (11.2%) samples in which MTB was detected whereas 222 (88.8%) samples had no MTB detected. Following re-analysis of positive pools, all 28 (100%) individual positive MTB samples were detected within the 17 positive pools, with 1 to 3 individual MTB positive samples per pool. The individual sputum samples were correctly identified by pooled sputum on Xpert MTB/RIF testing, with the sensitivity of 100% and specificity of 100%. Using pooling of sputum samples strategy, we saved 46.0% (115/250) of the cartridges. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0% and has the potential to increase the affordability of Xpert MTB/RIF testing in countries with limited resources, such as Tanzania.
文摘<strong>Background: </strong>The incidence of cervical, thoracic and lumbar spinal canal stenosis is low. It is difficult to identify the main focus and responsible segment, and it is also difficult to select the sequence of staging surgery. We report a patient with triple stenosis. <strong>Case Presentation:</strong> In this paper, we introduced a 61-year-old female patient with cervical, thoracic and lumbar spinal canal stenosis who had previously undergone “lumbar discectomy” in the outer hospital. The postoperative effect was not good and the symptoms were poor. The diagnosis was “cervical spinal stenosis and lumbar postoperative surgery”. The staged spinal canal decompression operation and Duhuo Jisheng Decoction (DHJSD) treatment were conducted in our hospital. After three months of follow-up, the functional and imaging results were satisfactory. <strong>Conclusions:</strong> The main focus and responsible spinal segment should be determined by the comprehensive analysis of medical history, signs, and images. Surgery combined with Chinese herbal medicine DHJSD therapy may be an effective treatment for this kind of disease.
基金supported by a project of the National Science&Technology Pillar Program during the Twelfth Five-year Plan Period(No.2012BAI29B07)the National Natural Science Foundation of China(No.81202898)
文摘The present study was designed to characterize the chemical constituents of Guge Fengtong Tablet(GGFTT).Based on the chromatographic retention behavior,fragmentation pathways of chemical components and the published literatures,a diagnostic ion filtering strategy with electrospray ionization quadrupole time-of-flight tandem mass spectrometry(HPLC-ESI-Q-TOF/MS) was established to identify the multiple bioactive constituents of GGFTT.The rapid identification of forty-seven components,including 18 phenolic acids,8 saponins,14 gingerol-related compounds,and 7 diarylhepatonoids,was accomplished using this newly developed method.The coupling of HPLC-ESI-Q-TOF/MS with the diagnostic ion filtering strategy was useful and efficient for the in-depth structural elucidation of chemical compounds of GGFTT.