Centralized isolation of Helicobacter pylori from multiple centers and transport condition influences

AIM:To evaluate the efficacy of centralized culture and possible influencing factors.METHODS:From January 2010 to July 2012,66452 patients with suspected Helicobacter pylori(H.pylori) infection from 26 hospitals in Zhejiang and Jiangsu Provinces in China underwent gastrointestinal endoscopy.Gastric mucosal biopsies were taken from the antrum for culture.These biopsies were transported under natural environmental temperature to the central laboratory in Hangzhou city and divided into three groups based on their transport time:5,24 and 48 h.The culture results were reported after 72 h and the positive culture rates were analyzed by a χ2 test.An additional 5736 biopsies from H.pylori-positive patients(5646 rapid urease test-positive and 90 14C-urease breath test-positive) were also cultured for quality control in the central laboratory setting.RESULTS:The positive culture rate was 31.66%(21036/66452) for the patient samples and 71.72%(4114/5736) for the H.pylori-positive quality control specimens.In the 5 h transport group,the positiveculture rate was 30.99%(3865/12471),and 32.84%(14960/45553) in the 24 h transport group.In contrast,the positive culture rate declined significantly in the 48 h transport group(26.25%; P < 0.001).During transportation,the average natural temperature increased from 4.67 to 29.14℃,while the positive culture rate declined from 36.67%(1462/3987) to 24.12%(1799/7459).When the temperature exceeded 24℃,the positive culture rate decreased significantly,especially in the 48 h transport group(23.17%).CONCLUSION:Transportation of specimens within 24 h and below 24℃ is reasonable and acceptable for centralized culture of multicenter H.pylori samples.

A Nomogram for Predicting the Severity of COVID-19 Using Laboratory Examination and CT Findings

Background: The outbreak of COVID-19 has a significant impact on the health of people around the world. In the clinical condition of COVID-19, the condition of critical cases changes rapidly with a high mortality rate. Therefore, early prediction of disease severity and active intervention play an important role in the prognosis of severe patients. Methods: All the patients with COVID-19 in Taizhou city were retrospectively included and segregated into the non-severe and severe group according to the severity of the disease. The clinical manifestations, laboratory examination results, and imaging findings of the 2 groups were analyzed for comparing the differences between the 2 groups. Univariate and multivariate logistic regression were used for screening the factors that could predict the disease, and the nomogram was constructed. Results: A total of 143 laboratory-confirmed cases were included in the study, including 110 non-severe patients and 33 severe patients. The median age of patients was 47 years (range, 4 - 86 years). Fever (73.4%) and cough (63.6%) were the most common initial clinical symptoms. By using the method of multivariate logistic regression, the variables to construct nomogram include age (OR: 1.052, 95% CI: 1.020 - 1.086, P = 0.001), body temperature (OR: 2.252, 95% CI: 1.139 - 4.450, P = 0.020), lymphocyte count (OR: 1.128, 95% CI: 1.000 - 1.272, P = 0.049), ADA (OR: 1.163, 95% CI: 1.023 - 1.323, P = 0.021), PaO2 (OR: 0.972, 95% CI: 0.953 - 0.992, P = 0.007), IL-10 (OR: 1.184, 95% CI: 1.037 - 1.351, P = 0.012), and bronchiectasis (OR: 3.818, 95% CI: 1.694 - 8.605, P = 0.001). The AUC of the established nomogram was 0.877. Conclusions: This study analyzed the cases of patients with COVID-19 in Taizhou city and constructed a model to predict the illness severity. When patients showed the features including older age, high body temperature, low lymphocyte count, low ADA value, low PaO2, high IL-10, and bronchiectasis sign in CT predicts a greater likelihood of severe COVID-19.

Kidney function change after transcatheter aortic valve replacement in patients with diabetes and/or hypertension

Aortic stenosis(AS)is a progressive heart valve disease occurring predominantly in older patients.According to a survey in a western country,the prevalence of AS is nearly 6.4%in patients over 75 years old(Carabello and Paulus,2009).Transcatheter aortic valve replacement(TAVR)is an alternative method for AS patients.Previous studies have described how up to 66%of TAVR patients have concomitant baseline kidney dysfunction(Ferro et al.,2015;Gargiulo et al.,2015).The majority of patients can benefit from the TAVR procedure with the recovery of kidney function.