Diagnostic Efficacy of Fecal Calprotectin in Inflammatory Bowel Disease: Systematic Literature Review

Introduction: Inflammatory bowel disease is a group of pathologies that include ulcerative colitis and Crohn's disease, which have similar manifestations. Currently, the diagnosis and monitoring of this disease rely mainly on endoscopic studies. Still, this method can hardly be applied to periodic disease monitoring as it is expensive, invasive, and not readily available. Fecal calprotectin is widely known, easy to use, and affordable, and it is currently the best-characterized biomarker for this pathology. Materials and methods: The research design is a systematic diagnostic test validation literature review. A search was conducted in different databases using the QUADAS-2 checklist to evaluate the methodological quality. Results: The initial search yielded 352,843 articles published chiefly in PubMed, followed by Scopus and Science Direct. After multiple filters, 221 papers were selected and wholly reviewed. They were evaluated with inclusion and exclusion criteria, with 18 articles being chosen. Conclusions: Fecal calprotectin is a reliable surrogate marker of endoscopic activity in IBD. However, there is a lack of consensus on delimiting a cut-off point and improving applicability and diagnostic accuracy. Colonoscopy remains the gold standard in all studies.

Introducción: La enfermedad inflamatoria intestinal es un conjunto de patologías entre las que están incluidas la colitis ulcerativa y la enfermedad de Crohn, las cuales tienen presentación similar. En la actualidad, el diagnóstico y seguimiento de dicha enfermedad se basa principalmente en estudios endoscópicos, pero este método difícilmente puede aplicarse a la monitorización periódica de la enfermedad al ser costoso, invasivo y con disponibilidad limitada. La calprotectina fecal cumple con ser ampliamente disponible, fácil de usar y de precio asequible, y actualmente es el biomarcador mejor caracterizado para el uso en esta patología. Metodología: Diseño de investigación tipo revisión sistemática de la literatura de validación de prueba diagnóstica. Se realizó una búsqueda en diferentes bases de datos y para la evaluación de la calidad metodológica se empleó la lista verificación QUADAS-2. Resultados: La búsqueda inicial para la selección de los artículos arrojó un total de 352.843 artículos publicados principalmente en PubMed seguido de Scopus y Science Direct. Después de múltiples filtros se logró elegir 221 artículos, los cuales se llevaron a revisión completa. Se valoraron con criterios de inclusión y exclusión, lo que determinó la elección final de 18 artículos. Conclusiones: La calprotectina fecal es un marcador sustituto fiable de la actividad endoscópica en la EII. Se evidencia la falta de consenso para delimitar un punto de corte y mejorar la aplicabilidad y la precisión diagnóstica. La colonoscopia sigue siendo en todos los estudios el estándar de oro.

Diagnostic efficacy of joint detection of Xpert MTBRIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis / 中国热带医学

@#Abstract: Objective　To investigate the diagnostic value of joint detection of Mycobacterium tuberculosis rifampicin resistance gene (Xpert MTB/RIF), Mycobacterium tuberculosis ribonucleic acid (TB-RNA) and Mycobacterium tuberculosis deoxyribonucleic acid (TB-DNA) in bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis. Methods A total of 806 patients with suspected smear-negative pulmonary tuberculosis admitted to our hospital from May 2020 to July 2022 were selected, 506 patients diagnosed as bacterial negative pulmonary tuberculosis by clinical, X-ray and sputum samples were classified as bacterial negative pulmonary tuberculosis group, and the other 300 patients with non-tuberculous pulmonary disease were classified as non-tuberculous pulmonary disease group. XpertMTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of all patients were detected. With clinical, X-ray and sputum specimen examination of mycobacterium tuberculosis as the gold standard, the diagnostic efficacy of alveolar lavage solution Xpert MTB/RIF, TB-RNA and TB-DNA alone and in combination was analyzed. Results The positive detection rates of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of the smear-negative pulmonary tuberculosis group and the non-tuberculosis pulmonary disease group were 69.96% (354/506) and 2.67% (8/300), 61.46% (311/506) and 5.00% (15/300), and 63.64% (322/506) and 8.00% (24/300), respectively. The rates in the smear-negative pulmonary tuberculosis group were higher than those in the non-tuberculosis lung disease group, and the differences were statistically significant (χ2=342.005, 246.930, 235.687, P<0.01). Compared with the gold standard, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of Xpert MTB/RIF in the diagnosis of smear-negative pulmonary tuberculosis were 69.96%, 97.33%, 80.15%, 97.79% and 65.77%, respectively; those values of TB-RNA were 61.46%, 95.00%, 73.95%, 95.40% and 59.38%, respectively; those values of TB-DNA were 63.64%, 92.00%, 74.19%, 93.06% and 60.00%, respectively; those values of combined diagnosis with Xpert MTB/RIF, TB-RNA and TB-DNA were 61.26%, 100.00%, 75.68%, 100.00% and 60.48%, respectively; the specificity and positive predictive value of combined detection were higher than those of single detection (P<0.05). Conclusions The joint detection of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid can improve the diagnostic efficacy of smear-negative pulmonary tuberculosis and is worthy of clinical promotion and application.

Diagnostic Efficacy of 18F-FDG PET/CT in Detecting Bone Marrow Infiltration in Patients with Newly Diagnosed Diffuse Large B-Cell Lymphoma / 生物医学与环境科学（英文）

OBJECTIVE@#Diffuse large B-cell lymphoma (DLBCL) is often associated with bone marrow infiltration, and 2-deoxy-2-(18F) fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) has potential diagnostic significance for bone marrow infiltration in DLBCL.@*METHODS@#A total of 102 patients diagnosed with DLBCL between September 2019 and August 2022 were included. Bone marrow biopsy and 18F-FDG PET/CT examinations were performed at the time of initial diagnosis. Kappa tests were used to evaluate the agreement of 18F-FDG PET/CT with the gold standard, and the imaging features of DLBCL bone marrow infiltration on PET/CT were described.@*RESULTS@#The total detection rate of bone marrow infiltration was not significantly different between PET/CT and primary bone marrow biopsy ( P = 0.302) or between the two bone marrow biopsies ( P = 0.826). The sensitivity, specificity, and Youden index of PET/CT for the diagnosis of DLBCL bone marrow infiltration were 0.923 (95% CI, 0.759-0.979), 0.934 (95% CI, 0.855-0.972), and 0.857, respectively.@*CONCLUSION@#18F-FDG PET/CT has a comparable efficiency in the diagnosis of DLBCL bone marrow infiltration. PET/CT-guided bone marrow biopsy can reduce the misdiagnosis of DLBCL bone marrow infiltration.

Clinical application of a novel urinary cytology detection system for bladder cancer / 现代泌尿外科杂志

【Objective】 To investigate the diagnostic efficacy of a novel bladder cancer detection system utilizing a urine cell processing kit for urine sample preservation and detection. 【Methods】 Patients with primary persistent gross hematuria and high recurrence risk of bladder cancer after transurethral resection of bladder tumor were prospectively enrolled between Dec.2021 and Mar.2022. Urine specimens were either added to (experimental group) or not added to (control group) the urine cell processing kit and were fixed on Day 0, Day 3 and Day 7. The sensitivity and specificity of the two groups were compared after the cells were fixed, produced, stained and read with body fluid cytology total staining technique. 【Results】 The sensitivity and specificity of the experimental group on Day 0 were 82.50% (33/40) and 87.50% (14/16), respectively; those of the control group were 79.49% (31/39) and 82.35% (14/17), respectively. On Day 3, the sensitivity and specificity of the experimental group were 76.32% (29/38)and 81.25% (13/16), respectively; those of the control group were 52.78% (19/36) and 78.57% (11/14), respectively. On Day 7, the sensitivity and specificity of the experimental group were 71.43% (25/35) and 72.22% (13/18), respectively; those of the control group were 35.71% (10/28) and 60.00% (9/15), respectively. The sensitivity of the experimental group on Day 3 and Day 7 was significantly higher than that of the control group (P<0.05). 【Conclusion】 This bladder cancer urine cytology detection system provides clear diagnostic advantages and can be used as an auxiliary examination before cystoscopy for patients with hematuria and those at high risk of bladder cancer recurrence. It can also be used as a bladder cancer screening tool for pre-screening a large sample of people in order to achieve early diagnosis and treatment of bladder cancer.

Application of one-beat acquisition with wide detector CT in coronary artery CT angiography of patients with atrial fibrillation / 西安交通大学学报(医学版)

【Objective】 To evaluate the effect of one-beat acquisition with wide detector CT on the image quality and diagnostic efficiency of coronary CT angiography (CCTA) in patients with atrial fibrillation. 【Methods】 A total of 52 consecutive patients with atrial fibrillation, including 31 males, (67.32±11.45) years old, who underwent CCTA from July 2022 to February 2023, were analyzed retrospectively. All patients underwent one-beat acquisition CCTA. The subjective and objective image quality of the coronary arteries was evaluated, and using invasive coronary catheter angiography as the gold standard, the diagnostic efficacy of stenosis degrees above moderate and severe degrees was calculated, respectively. 【Results】 Subjective evaluation results: 92.31% (384/416) of the vascular segments were rated as excellent or good, and the diagnosable rate reached 98.08% (408/416, subjective score ≥3 points). Objective evaluation results: The CT value of the right coronary artery, anterior descending branch, and circumflex branch was (433.41±95.17)HU, (422.69±92.81)HU and (420.27±95.43)HU, respectively; the contrast-to-noise ratio was 38.46±7.54, 32.46±13.78 and 37.74±8.89, respectively. The total diagnostic accuracy, sensitivity, and specificity was 94.71%, 87.9% and 96.62%, respectively, for moderate stenosis and 96.15%, 83.64% and 98.06% for severe stenosis. 【Conclusion】 One-beat acquisition with wide detector CT can obtain high-quality coronary artery images and high diagnostic accuracy for patients with atrial fibrillation without radiation dose increase to patients. It has good clinical application value for patients with atrial fibrillation.

Eficacia de la impronta citológica peritoneal para decidir cuándo detener los lavados peritoneales programados / Efficacy of Peritoneal Cytological Imprinting in Deciding When to Stop Scheduled Peritoneal Lavages

Introducción: La no existencia de un parámetro preestablecido que permita determinar el momento preciso para suspender los lavados peritoneales programados, conlleva a que muchas veces se realice un número insuficiente de ellos, o tal vez estos se prolonguen de forma innecesaria y aumentan las probabilidades de fallecimiento del paciente. Objetivo: Determinar la eficacia de la impronta citológica peritoneal para decidir cuándo detener los lavados peritoneales programados. Métodos: Se realizó un estudio descriptivo de exactitud diagnóstica, en una serie de casos, con recogida prospectiva de datos desde enero de 2010 hasta diciembre de 2014, en el Hospital Provincial Clínico-Quirúrgico Docente "Celia Sánchez Manduley. La muestra quedó conformada por 42 pacientes que fueron tratados por peritonitis secundaria persistente. Se clasificaron según cuatro categorías de correlación y se tomó como estándar de referencia a la biopsia por parafina. Resultados: Las muestras con inflamación aguda peritoneal y curación de la inflamación peritoneal se identificaron correctamente en 39/42 casos, por lo tanto, el porcentaje predictivo global de la impronta citológica fue del 92,86 por ciento. La sensibilidad en el diagnóstico de inflamación aguda peritoneal fue del 100 por ciento, la especificidad del 92,68 por ciento, el valor predictivo positivo fue del 24,99 por ciento y el valor predictivo negativo del 100 por ciento. Las razones de verosimilitudes positiva y negativa fueron 13,67 y 0, respectivamente. El coeficiente (κ) fue de 0,376. Conclusiones: La impronta citológica peritoneal constituye un método diagnóstico eficaz para descartar inflamación aguda peritoneal cuando el resultado es negativo y se consideró de gran utilidad para detener los lavados peritoneales programados(AU)

Introduction: The lack of a pre-established parameter that allows determining the precise moment to suspend the scheduled peritoneal lavages, often leads to performing insufficient number of them, or perhaps these are unnecessarily prolonged, increasing the probability of the patient´s death. Objective: To determine the efficacy of peritoneal cytological imprinting in deciding when to stop scheduled peritoneal lavages. Methods: A descriptive study of diagnostic accuracy was carried out, in a series of cases, with prospective data collection in the five-year period from 2010 to 2014 at Celia Sánchez Manduley Provincial Clinical-Surgical Teaching Hospital. The sample was made up of 42 patients who were treated for persistent secondary peritonitis. They were classified according to four correlation categories, taking paraffin biopsy as reference standard. Results: Samples with acute peritoneal inflammation and healing of peritoneal inflammation were correctly identified in 39/42 cases. Therefore, the global predictive percentage of the cytological imprint was 92.86 percent. The sensitivity in the diagnosis of acute peritoneal inflammation was 100 percent, the specificity was 92.68 percent, the positive predictive value was 24.99 percent, and the negative predictive value was 100 percent. The positive and negative likelihood ratios were 13.67 and 0, respectively. Cohen's kappa coefficient (κ) was 0.376. Conclusions: The peritoneal cytological imprint is an effective diagnostic method to rule out acute peritoneal inflammation when the result is negative and it was considered very useful to stop scheduled peritoneal lavages(AU)

Glycated Haemoglobin : It抯 Diagnostic and Prognostic Efficacy in Various Clinical Scenarios

Glycated Haemoglobin (HbA1c) gives a measure of long term Glycemic control. However, how the values of HbA1c affects the outcome in various comorbidities and its effect on the short term and long term outcome of these comorbidities remains a matter of Grey Zone. Cardiovascular Diseases, Chronic Kidney Disease, Anemia, Chronic Liver Disease etc, can alter the interpretation of HbA1C level, where it may not reflect the appropriate Glycemic control. Hence this review is done to look for the evidence and appropriateness of HbA1c as Diagnostic and Prognostic marker for Glycemic control in various clinical scenario.

Study on ultrasonic characteristics of eccrine spiradenomas and diagnostic efficacy / 中华超声影像学杂志

Objective:To investigate the ultrasonic characteristics of eccrine spiradenoma (ES) and to analyze the diagnostic value.Methods:Nineteen ES patients with 24 lesions confirmed by pathology in 3 grade-A tertiary hospitals from October 2011 to October 2021 were enrolled as study group, and in the same time, 46 patients with 46 masses in the skin and muscular tissues with clinical features of automatic pain and/or tenderness were selected as control group. The ultrasonographic characteristics of the two groups were analyzed retrospectively, including anatomical location, shape, boundary, internal echogenicity, echogenic distribution, calcification, posterior acoustic effect, and vascularity. The ultrasonographic characteristics of the two groups were compared, and the risk sonographic characteristics of ES were obtained by multivariate logistic regression analysis. The sensitivity and specificity of ultrasound characteristics for the diagnosis of ES were calculated.Results:The ultrasonic characteristics of the two groups had significant differences in lobulated shape, boundary, internal echogenicity and posterior acoustic effect (χ 2=32.65, 15.65, 5.77, 13.63; all P<0.01). Multivariate logistic regression analysis showed that lobulated shape and posterior acoustic enhancement were the risk ultrasonic characteristics of ES. The sensitivity and specificity of lobulated shape and posterior acoustic enhancement characteristics in the diagnosis of ES were 79.17%, 89.13%, 95.83% and 47.83%, respectively; and the sensitivity and specificity of the combination of lobulated shape and posterior acoustic enhancement characteristics in the diagnosis of ES were 79.17% and 97.83%, respectively. Conclusions:The lobulated shape and posterior acoustic enhancement characteristics are important for the identification of ES, which have higher diagnostic efficacy for ES.

Characterization and diagnostic efficacy of Rose-Bengal plate agglutination test, standard-tube agglutination test and enzyme-linked immunosorbent assay methods in detecting brucellosis / 中国热带医学

@#Abstract: Objective　To study the characteristics and diagnostic efficacy of Rose-Bengal plate agglutination test (RBPT), standard-tube agglutination test (SAT) and enzyme-linked immunosorbent assay (ELISA) in the diagnosis of brucellosis. Methods　A total of 489 suspected brucellosis patients with complete records, who admitted to Xing'anmeng People's Hospital from March 2020 to May 2021, were selected as the subjects. The diagnostic value of SAT, RBPT and ELISA for brucellosis was analyzed with exposure history + clinical symptoms + serological test/brucellosis isolation and culture as the gold standard. Results　Of the 489 suspected patients, 183 (37.42%) were diagnosed with brucellosis, while 234 (47.85%), 148 (30.27%) and 195 (39.88%) were positive by RBPT, ELISA and SAT, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of RBPT in the diagnosis of brucellosis were 95.08%, 80.39%, 74.36%, 96.47%, and 85.89%, respectively; the values of the above parameters for ELISA were 78.69%, 98.69%, 97.30%, 88.56%, and 91.21%, respectively; those values of SAT were 98.36%, 95.10%, 92.31%, 98.98%, and 96.32%, respectively. The sensitivity of RBPT was significantly higher than ELISA, but the specificity and accuracy were significantly lower than ELISA (all P<0.05). The sensitivity and accuracy of SAT diagnosis were significantly higher than ELISA, but the specificity was significantly lower than ELISA (all P<0.05). There was no significant difference between SAT and RBPT in the sensitivity of diagnosis, but the specificity and accuracy were significantly higher than those of RBPT (P<0.05). Conclusion　RBPT and SAT have high sensitivity in diagnosis of brucellosis, while ELISA has high specificity in diagnosis. RBPT with high sensitivity and convenient operation can be used for primary screening in field detection, and then the other two methods can be used for rechecking, so as to further improve the efficiency and accuracy of diagnosis of brucellosis.

Diagnostic efficacy of indirect haemagglutination assay for detection of Schistosoma japonicum infections among boatmen and fishermen in the Dongting Lake region / 中国血吸虫病防治杂志

OBJECTIVE@#To evaluate the diagnostic efficacy of indirect haemagglutination assay (IHA) for detection of Schistosoma japonicum infections among boatmen and fishermen in Dongting Lake region, so as to provide insights into improving the schistosomiasis surveillance program among boatmen and fishermen.@*METHODS@#The boatmen and fishermen were detected for S. japonicum infections using IHA and Kato-Katz technique or miracidium hatching test nylon gauze simultaneously at schistosomiasis testing sites in the anchor sites for boatmen and fishermen in the Dongting Lake region during the period from 2014 to 2016, and using IHA for serological screening followed by parasitological testing of seropositives during the period from 2017 to 2019. The sensitivity and specificity of IHA were evaluated for detection of S. japonicum infections among boatmen and fishermen, with the 2014-2016 parasitological testing results as a gold standard. In addition, the seroprevalence of S. japonicum infections was compared among boatmen and fishermen with different characteristics and among years.@*RESULTS@#A total of 306 schistosomiasis testing sites were assigned for boatmen and fishermen, and a total of 143 360 person-time boatmen and fishermen were tested for S. japonicum infections in the Dongting Lake region from 2014 to 2019. The sensitivity and specificity of IHA were 69.9%, 97.3% and 96.1% (χ2 = 74.6, P < 0.05), and 70.9%, 74.5% and 71.9% for detection of S. japonicum infections from 2014 to 2016 (χ2 = 29.4, P < 0.05), respectively. The seroprevalence of S. japonicum infections reduced from 30.3% in 2014 to 1.8% in 2019 among boatmen and fishermen, appearing an overall tendency towards a decline (Z = 1 552.4, P < 0.05). In addition, male, individuals at ages of 45 to 60 years, full-time boatmen and fishermen were more likely to be seropositive for S. japonicum infections (all P values < 0.05).@*CONCLUSIONS@#The seroprevalence of S. japonicum infections appeared a tendency towards a decline among boatmen and fishermen in the Dongting Lake region year by year from 2014 to 2019. IHA presented a high efficacy for screening of S. japonicum infections among boatmen and fishermen in the Dongting Lake region.

Establishment and evaluation of clinical diagnostic scoring system for septic cardiomyopathy / 中华危重病急救医学

Objective:To establish a clinical diagnostic scoring system for septic cardiomyopathy (SCM) and evaluate its diagnostic efficacy.Methods:A prospective cohort study was performed. Patients with sepsis and septic shock admitted to the department of emergency of China Rehabilitation Research Center were enrolled from January 2019 to December 2020. The baseline information, medical history, heart rate (HR), mean arterial pressure (MAP), body temperature and respiratory rate (RR) on admission were recorded. Laboratory indexes such as white blood cell count (WBC), hypersensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and blood lactic acid (Lac) were measured. Transthoracic echocardiography was conducted within 24 hours and on the 7th after admission. Sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluationⅡ(APACHEⅡ), and nutritional risk screening 2002 scale (NRS2002) were also assessed. The patients were divided into two groups according to whether SCM occurred or not. The risk factors of SCM were screened by univariate and multivariate Logistic regression. The cut-off value of continuous index was determined by receiver operator characteristic curve (ROC curve) and discretized concerning clinical data. The regression coefficient β was used to establish the corresponding score, and the clinical diagnostic score system of SCM was established. The diagnostic value of the model was evaluated by ROC curve.Results:In total, 147 patients were enrolled in the study and the incidence of SCM was 28.6% (42/147). Univariate Logistic regression analysis showed the risk factors of SCM included: ① continuous indicators: age, NT-proBNP, RR, MAP, Lac, NRS2002, SOFA, APACHEⅡ; ② discrete indicators: shock, use of vasoactive drugs, history of coronary heart disease, acute kidney injury (AKI). Multivariate Logistic regression analysis after discretization of above continuous index showed that age≥87 years old, NT-proBNP≥3 000 ng/L, RR≥30 times/min, Lac≥3 mmol/L and SOFA≥10 points were independent risk factors for SCM [age ≥87 years: odds ratio ( OR) = 3.491, 95% confidence interval (95% CI) was 1.371-8.893, P = 0.009; NT-proBNP≥3 000 ng/L: OR = 2.708, 95% CI was 1.093-6.711, P = 0.031; RR≥30 times/min: OR = 3.404, 95% CI was 1.356-8.541, P = 0.009; Lac≥3 mmol/L: OR = 3.572, 95% CI was 1.460-8.739, P = 0.005; SOFA≥10 points: OR = 8.693, 95% CI was 2.541-29.742, P = 0.001]. The clinical diagnostic score system of SCM was established successfully, which was composed of age≥87 years old (1 point), NT-proBNP ≥ 3 000 ng/L(1 point), RR≥30 times/min (1 point), Lac≥3.0 mmol/L (1 point), SOFA≥10 points (2 points), and the total score was 6 points. ROC curve analysis showed the cut-off value of the scoring system for diagnosing SCM was 3 points, the area under ROC curve (AUC) was 0.833, 95% CI was 0.755-0.910, P < 0.001, with the sensitivity of 71.4%, and specificity of 86.7%. Conclusion:The clinical diagnostic scoring system has good diagnostic efficacy for SCM and contributes to early identification of SCM for clinicians.

Application value of lung ultrasound in the diagnosis and severity assessment of ventilator-associated pneumonia / 中华危重病急救医学

Objective:To explore the value of bedside lung ultrasound in the early diagnosis and severity assessment of ventilator-associated pneumonia (VAP).Methods:A prospective observational study was conducted in 60 patients with VAP (VAP group) and 62 patients without VAP (control group) who were admitted to department of intensive care unit of General Hospital of Ningxia Medical University from September 2018 to July 2020. The gender, age and underlying diseases of non-VAP group were matched with VAP group. The general clinical data such as gender, age, underlying diseases, department source of the patient, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment (SOFA) score were recorded. The body temperature, white blood cell count (WBC), procalcitonin (PCT), oxygenation index (PaO 2/FiO 2), alveolar artery oxygen differential pressure (P A-aDO 2) were recorded. During mechanical ventilation, the patient's body temperature, WBC, sputum characteristics, and the change of the lung ultrasound were dynamically observed. With or without dynamic air bronchogram, lung ultrasound was considered to be positive as long as there were small subpleural consolidation or tissue-like sign. Ventilator-associated pneumonia lung ultrasound score (VPLUS) and lung ultrasound score (LUSS) were performed, and chest CT scan was completed on the same day. Use positive chest CT scan as the standard to evaluate the diagnostic efficacy of lung ultrasound, VPLUS score, and the combination of the two with PCT for VAP. LUSS was used to assess the severity of disease in patients with VAP. The correlation between LUSS and PaO 2/FiO 2, P A-aDO 2, APACHEⅡscore and SOFA score were analyzed. Results:① General information: compared with non-VAP group, VAP group had more emergency surgery patients [51.7% (31/60) vs. 33.9% (21/62), P = 0.047], APACHEⅡ score and SOFA score were significantly higher (APACHEⅡscore: 15.4±5.7 vs. 13.4±3.4, P = 0.021; SOFA score: 8.8±4.2 vs. 6.3±3.3, P < 0.001), body temperature tended to rise (℃: 38.3±0.8 vs. 38.0±0.9, P = 0.054), more patients had airway purulent secretions [65.0% (39/60) vs. 41.9% (26/62), P = 0.011], and mechanical ventilation time and length of ICU stay were longer [mechanical ventilation time (days): 10.5 (6.6, 15.0) vs. 4.3 (3.0, 6.0), P < 0.001; length of ICU stay (days): 14.8 (9.0, 18.0) vs. 6.0 (4.0, 9.1), P < 0.001], 28-day mortality rate was higher [31.7% (19/60) vs. 9.7% (6/62), P = 0.003].② Diagnostic efficacy evaluation: when lung ultrasound was positive, VPLUS≥3 and PCT > 0.5 μg/L were used separately for the diagnosis of VAP, the sensitivity was 73.3%, 75.0%, 61.7%, respectively; the specificity was 80.6%, 58.1% and 59.7%, respectively; the 95% confidence interval (95% CI) was 0.685-0.842, 0.574-0.748, 0.514-0.694, respectively, all P < 0.05, positive lung ultrasound had good sensitivity and specificity. When positive lung ultrasound or VPLUS≥3 were combined with PCT > 0.5 μg/L for tandem test, the specificity of VAP diagnosis was increased to 95.2% and 83.9%, respectively; but the specificity of VAP diagnosis of positive lung ultrasound combined with PCT > 0.5 μg/L was higher than VPLUS ≥3 combined with PCT > 0.5 μg/L (95.2% vs. 83.9%, P < 0.05).③ Correlation analysis: LUSS showed a significant positive correlation with APACHEⅡ and SOFA score ( r values were 0.407, 0.399, P values were 0.001, 0.002, respectively), LUSS had no relation with PaO 2/FiO 2 and P A-aDO 2 ( r values were 0.189, -0.064, P values were 0.629, 0.149, respectively). Conclusions:Lung ultrasound can early detect VAP , and its diagnostic specificity is significantly improved when combined with PCT > 0.5 μg/L. LUSS is closely related to the severity of disease in VAP patients, therefore, lung ultrasound may be an effective method for early diagnosis and efficacy evaluation of VAP patients.

Efficacy evaluation of a SARS-CoV-2 diagnostic reagent for total antibody detection / 中国输血杂志

【Objective】 To track and evaluate the clinical diagnostic efficacy of an enzyme linked immunosorbent assay (ELISA) kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 【Methods】 Total antibody (TAb) specific to SARS-CoV-2 in blood donors were determined using ELISA reagent. TAb positive donors were followed up 1 month after blood donation. SARS-CoV-2 specific IgG, IgM and pseudotype lentivirus based neutralization test (ppNAT) were conducted for TAb positive blood donors and follow-up samples. ppNAT and IgG antibodies simultaneously positive in ppNAT positive samples and its follow-up samples was used as the standard for antibodies validation. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and Youden index of SARS-CoV-2 TAb ELISA were analyzed. 【Results】 Among 16 016 blood donors from January 31 to April 28, 2020, 61 donors were diagnosed as TAb positive, 6 cases were positive for ppNAT, in which 2 were positive for both ppNAT and IgG; 4 of 46 TAb positive follow-up samples were positive for ppNAT, in which 2 were positive for IgG simultaneously. The sensitivity, specificity, PPV, NPV, accuracy, Youden index, false positive rate and false negative rate of SARS-CoV-2 TAb reagent were 100.00%, 99.60%, 3.28%, 100.00%, 99.60%, 99.60%, 0.40% and 0.00%, respectively. 【Conclusion】 SARS-CoV-2 TAb ELISA has high sensitivity and good clinical diagnostic efficacy, but the false positive rate is relatively high in low-risk blood donors. Therefore, ppNAT, IgG and follow-up results should be fully considered in clinical in order to analyze the positive results and determine the infection status more accurately.

Investigation of risk factors for gastric cancer in Hanzhong area and establishment of a gastric cancer risk prediction model based on gastric function index / 公共卫生与预防医学

Objective To investigate the risk factors of gastric cancer in Hanzhong area and establish a gastric cancer risk prediction model based on gastric function indexes. Methods A questionnaire survey was conducted on 227 patients with gastric and non-gastric cancer admitted to the Department of Gastroenterology of Hanzhong Central Hospital from January 2018 to January 2019. The diet, lifestyle habits, family history, and past history of the subjects were collected. Serological tests (including serum PGⅠ,Ⅱ, and G-17), gastroscopy and pathological examination of the samples were carried out. Multi-factor Logistic regression analysis was performed to analyze the high risk factors. The efficacy of serum gastric function for gastric cancer screening was assessed through ROC curve. Results There were no significant differences in the distribution of age (χ2=0.054, P=0.816), gender (χ2=3.823, P=0.051) and BMI (χ2=5.569, P=0.135) between the gastric cancer and non-gastric cancer groups, suggesting that the clinical data between the two groups was comparable. Multivariate logistic regression analysis showed that smoked food intake (P=0.031, 95% CI: 1.150 ~ 17.545) and hyperlipidemia (P=0.039, 95% CI:0.216~0.960) were high risk factors for gastric precancerous lesions, other factors did not show significant high risk (P>0.05). The results of ROC curve showed that the diagnostic efficacy of combined PG I, PG II, and G-17 was significantly higher than that of PG I, PGⅡ, or G-17 alone (P<0.05). Conclusion The risk factors of gastric cancer in Hanzhong area mainly included the intake of smoked food and hyperlipidemia. Patients can be advised to pay attention to diet during clinical treatment. Based on gastric function indexes PG, PGⅡ and G-17, the diagnosis of gastric precancerous lesions had a good prediction. The combined diagnosis is more effective, which provided a theoretical basis for the early diagnosis of clinical gastric cancer.

Concordancia diagnóstica del ultrasonido versus Rayos X, para fracturas de huesos pequeños, Servicio de Emergencia del Hospital de los Valles, Cumbayá, 2015-2017 / Ultrasound diagnostic agreement and X-rays, for fractures of small bones, Emergency Service of the Hospital de los Valles, Cumbayá, 2015-2017

Los traumatismos de extremidades son una de las principales causas de morbilidad en nuestro medio. El ultrasonido ha surgido como un elemento de diagnóstico de bajo costo, rápido y sin efectos que deterioren la salud. La exploración del componente músculo esquelético con ultrasonido de las extremidades se puede hacer con facilidad pero requiere de entrenamiento para la interpretación adecuada de las imágenes. Los estudios convencionales como la radiografía y tomografía son útiles, sin embargo, son de mayor costo y con riesgos para la salud. Los equipos de ultrasonido son de fácil instalación y han demostrado tener utilidad en el diagnóstico de fracturas de huesos largos especialmente. Objetivo: comparar la efectividad del ultrasonido versus rayos X en traumatismos cerrados agudos en extremidades superiores e inferiores en pacientes con sospecha de fracturas de huesos pequeños. Materiales y Métodos: Este fue un estudio de corte-transversal que incluyó a cuarenta y tres pacientes consecutivos ingresados ​​en el departamento de emergencias con sospecha de fracturas de huesos pequeños de extremidades debido a un trauma. Fueron evaluados por ultrasonido y rayos X para establecer su concordancia. El diagnóstico final de la presencia o no de una fractura fue establecido por el criterio clínico de un traumatólogo. Resultados: Con el método ecográfico fue posible diagnosticar un 26% más de fracturas que con los rayos x. Hubo una moderada concordancia 73.68% y un índice kappa 0,51 p<0.0002. Conclusiones: La concordancia establecida es moderada, probablemente a expensas de la mayor capacidad de diagnóstico del ultrasonido.

Establishment of a predictive model of post-percutaneous coronary intervention depression in patients with coronary heart disease and its effect analysis / 中国实用护理杂志

Objective@#To screen the risk factors of depression in patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI), and to construct a predictive model of depression in patients with CHD after PCI and to analyze its diagnostic efficacy.@*Methods@#A total of 3 048 patients with CHD who were treated in our hospital from April 2015 to January 2019 were selected as the study subjects. 967 patients with depression after PCI were selected as depression group. 967 patients without depression after PCI were randomly selected as CHD group according to 1:1 ratio. Univariate and multivariate logistic regression analysis were used to analyze the risk factors of depression in patients with CHD after PCI, and to construct a predictive model of depression in patients with CHD after PCI. The ROC curve was used to analyze the diagnostic efficacy of a predictive model of depression in patients with CHD after PCI.@*Results@#Of 3 048 patients with CHD, 967 (31.73%) suffered from depression after PCI. There were significant differences in age, sex, type D personality, smoking history, NYHA classification, number of stents implanted, solitary living, emergency PCI, Gensini score and education level between the two groups (P<0.05). Logistic regression analysis showed that age, type D personality, NYHA grade, solitude and education were risk factors for depression after PCI. The area under ROC curve of depression model after PCI in CHD patients was 0.961 (95% CI: 0.910-0.987), the sensitivity and specificity were 96.00% and 90.82% respectively.@*Conclusion@#The model constructed in this study can predict the risk of depression in patients with CHD after PCI and is more effective.

Analysis of the significance of cerebral perfusion imaging combined with CT angiography in the diagnosis and treatment plan of patients with ischemic stroke / 中国医师进修杂志

Objective@#To investigate the significance of cerebral perfusion imaging combined with CT angiography (CTA) in the diagnosis and treatment plan of patients with ischemic stroke.@*Methods@#Total of 44 patients with acute cerebral infarction were enrolled in Taizhou First People′s Hospital from January 2018 to September 2018. Cerebral perfusion imaging and CTA examination were performed simultaneously within 12 h after the onset of the disease. The images of perfusion imaging were processed using an image workstation to measure the level of perfusion parameters in the ischemic region of the patient′s brain. The head and neck of the patient were measured by CTA. The angiography was performed, and the cerebral angiography results of all patients were as the gold standard. The clinical diagnosis and diagnostic efficacy of different examination methods in patients with ischemic stroke was observed and compared, and the differences in the parameters of perfusion imaging between different perfusion abnormal areas and normal control areas were compared.@*Results@#When patients′ cerebral angiography and single-photon emission computed tomography (SPECT) was as the gold standard for comparison, cerebral blood flow (CBF) and mean transit time (MTT) had the highest accuracy among all parameters of perfusion imaging. The accuracy rate of perfusion imaging+CTA was 93.2%, with a specificity of 100.0% and a sensitivity of 90.1%, which was significantly higher than that of the clinical efficacy of single diagnosis.@*Conclusions@#Perfusion imaging combined with CTA can provide important supplementary reference information for clinical diagnosis and treatment of patients with ischemic stroke.

Determination of serum miR-128 level in patients with first-visit Parkinson’s disease and its related study / 临床神经病学杂志

To study the changes of serum miR-128 in patients with first-visit Parkinson’s disease (PD) before and after treatment, and the correlation between serum miR-128 and unified PD rating scale (UPDRS) scores and inflammatory factors in patients with PD. It is helpful to explore the diagnostic value and pathogenesis of miR-128 in PD. Methods Serum miR-128 levels were measured in 54 patients with first-visit PD ( first-visit PD group) before and after treatment, and were compared with 50 cases of healthy controls (healthy control group). The UPDRS scale was evaluated and the serum levels of IL-1β and TNF-α were measured, and the results were analyzed. Results The level of serum miR-128 in first-visit PD group was significantly lower than that in healthy control group (t = 8. 87, P< 0.01 ). After two months of treatment, the level of serum miR-128 in first-visit PD group was significantly higher than that before treatment (t= -5.13, P<0.01), and the UPDRS score was significantly lower than that before treatment (t=9.67, P<0.01). There was a negative correlation between serum miR-128 level and UPDRS score, IL-1β and TNF-α levels in first-visit PD group, respectively ( r= -0.763, r= -0.656, r= -0.674; all P<0.01). The area under the working characteristic curve of serum miR128 was 0.882 (95% CI:0.776-0. 952, P<0.01 ). The sensitivity of diagnosis of PD was 72. 0% , and the specificity was 88. 9%. Conclusion Among the first first-visit PD patients, the level of serum miR-128 is abnormal, and it can be used as a better index of peripheral blood for evaluating the condition and auxiliary diagnosis of PD, which plays an important role in the pathogenesis of depression.

Analysis of the significance of cerebral perfusion imaging combined with CT angiography in the diagnosis and treatment plan of patients with ischemic stroke / 中国医师进修杂志

investigate the significance of cerebral perfusion imaging combined with CT angiography (CTA) in the diagnosis and treatment plan of patients with ischemic stroke. Methods Total of 44 patients with acute cerebral infarction were enrolled in Taizhou First People′s Hospital from January 2018 to September 2018. Cerebral perfusion imaging and CTA examination were performed simultaneously within 12 h after the onset of the disease. The images of perfusion imaging were processed using an image workstation to measure the level of perfusion parameters in the ischemic region of the patient′s brain. The head and neck of the patient were measured by CTA. The angiography was performed, and the cerebral angiography results of all patients were as the gold standard. The clinical diagnosis and diagnostic efficacy of different examination methods in patients with ischemic stroke was observed and compared, and the differences in the parameters of perfusion imaging between different perfusion abnormal areas and normal control areas were compared. Results When patients′ cerebral angiography and single-photon emission computed tomography (SPECT) was as the gold standard for comparison, cerebral blood flow (CBF) and mean transit time (MTT) had the highest accuracy among all parameters of perfusion imaging. The accuracy rate of perfusion imaging +CTA was 93.2% , with a specificity of 100.0% and a sensitivity of 90.1%, which was significantly higher than that of the clinical efficacy of single diagnosis. Conclusions Perfusion imaging combined with CTA can provide important supplementary reference information for clinical diagnosis and treatment of patients with ischemic stroke.

Establishment of a predictive model of post-percutaneous coronary intervention depression in patients with coronary heart disease and its effect analysis / 中国实用护理杂志

Objective To screen the risk factors of depression in patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI), and to construct a predictive model of depression in patients with CHD after PCI and to analyze its diagnostic efficacy. Methods A total of 3 048 patients with CHD who were treated in our hospital from April 2015 to January 2019 were selected as the study subjects. 967 patients with depression after PCI were selected as depression group. 967 patients without depression after PCI were randomly selected as CHD group according to 1:1 ratio. Univariate and multivariate logistic regression analysis were used to analyze the risk factors of depression in patients with CHD after PCI, and to construct a predictive model of depression in patients with CHD after PCI. The ROC curve was used to analyze the diagnostic efficacy of a predictive model of depression in patients with CHD after PCI. Results Of 3 048 patients with CHD, 967 (31.73% ) suffered from depression after PCI. There were significant differences in age, sex, type D personality, smoking history, NYHA classification, number of stents implanted, solitary living, emergency PCI, Gensini score and education level between the two groups (P<0.05). Logistic regression analysis showed that age, type D personality, NYHA grade, solitude and education were risk factors for depression after PCI. The area under ROC curve of depression model after PCI in CHD patients was 0.961 (95% CI: 0.910-0.987), the sensitivity and specificity were 96.00% and 90.82% respectively. Conclusion The model constructed in this study can predict the risk of depression in patients with CHD after PCI and is more effective.