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Objective:To study the correlation between urobilirubin and urine cast, and further assess the accuracy of positive urobilirubin as a new microscopic review rule for urinalysis.Methods:505 inpatients′ urine samples were selected from Wuhan Union Hospital during October 2021 and April 2022, including 339 males and 166 females with an age range of 51.45±16.64 years. 202 samples with positive urobilirubin were selected as study objects and were divided into two groups, one group includes 70 samples with positive urine protein and another group includes 132 samples with negative urine protein. According to the clinical departments′ distribution of the study objects, 40 samples from the corresponding clinical departments with negative urobilirubin were selected as a control group. 200 samples were selected for verification test one without consideration of the clinical department distribution and the urinalysis results and another 63 samples with positive urobilirubin and negative positive urine protein were selected for verification test two. After the IQC of each instrument was passed, the liver and renal functions were detected and the urine samples were detected by dry chemical analysis, automated sediment analyzer, microscope exam after centrifugation, and urine β 2-MG and RBP quantitative detections. Two microscope review rules were defined, rule one: if any of WBC, RBC, PR0/CAST were different between the dry chemical system and urine sediments analyzer and the urine protein was positive by dry chemical analysis. Rule two: positive urobilirubin plus rule one. We estimated the accuracies of the two rules by Mann-Whitney U test and χ 2 test. Results:①The positive rates of the cast of study objects and patients with negative urine protein were 58.42% (118/202)and 55.30%(73/132) respectively, both higher than that of the control group(20%,8/40) (χ 2=19.74,15.36, P<0.01), and on univariate analysis, positive urobilirubin was found to be a significant predictor of urine cast when the urine protein was negative by dry chemical system[OR(95% CI):5.619(2.466-12.806), P<0.01].②Four protocols were used: positive urine protein by dry chemical method, positive cast result by UF-5000i, rule one and rule two. As for the study group, the total review rates of each protocol were 34.65%(70/202), 30.69%(62/202), 60.89%(123/202), and 100% (202/202)respectively, and the false negative rates of the cast were 35.64%(72/202), 30.20%(61/202), 12.87%(26/202)and 0 respectively. As for patients with positive urobilirubin and negative urine protein, the total review rates of each protocol were 0, 22.73%(30/132), 40.15%(53/132), and 100%(132/132) respectively and the false negative rates of the cast were 54.55%(72/132), 34.85%(46/132), 19.70%(26/132)and 0 respectively.③The results of verification test one showed there were no significant differences between the total review rates(50.50% vs 52.50%, χ 2=0.16, P>0.05) and the false negative rates of cast detection(4.50% vs 2.50%, χ 2=1.15, P>0.05)of rule one and rule two. The results of verification test two showed the total review rates of rule two was higher than that of rule one(100% vs 46.03%, χ 2=46.57, P<0.01), and the false negative rates of cast detection of rule two was significantly lower than that of rule one(0 vs 14.29%, χ 2=9.69, P<0.01). Conclusions:Positive urobilirubin can be used to predict urine cast when urine protein was negative by dry chemical method. And we recommended that positive urobilirubin should be considered as a rule of microscopic review of urinalysis to decrease the false negative rate of cast detection of samples with positive urobilirubin and negative urine protein dry chemical method.
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Objective:To summarize the clinical and imaging presentations of stapical footplate hernia related to inner ear malformation (SFH-Re-IEM).Methods:The clinical and imaging data of 19 patients (24 ears) with SFH-Re-IEM from Shandong Provincial ENT Hospital between June 2014 to June 2022 were retrospectively analyzed. The clinical presentations and headache and the high resolution CT (HRCT) and MRI findings including associated inner ear malformation (IEM) type, internal auditory canal (IAC) malformation, bony defect of the stapical footplate, the extent, margin, density and signal of the herniation cysts, the density and signal of ipsilateral intratympanic, cochlear osseous labyrinthitis were recorded.Results:Among 19 SFH-Re-IEM patients, including 14 males and 5 females, 3 (1, 12) years old. All of the affected ears presented sensorineural or mixed hearing loss, 1 ear for moderate, 7 ears for severe and 16 ears for extremely severe. Besides this, the vertigo in 1 case, otalgia and ear fullness in 2 cases were found, and the others were detected accidentally. Among 24 ears with SFH-Re-IEM, 9 ears (37.5%) consisting with incomplete partition type Ⅰ, 3 ears (12.5%) with common cavity, 7 ears (29.2%) with cochlear aplasia, 3 ears (12.5%) with cochlear dysplasia type Ⅱ, and 2 ears (8.3%) with Mondini deformity were found respectively. Four ears (16.7%) were associated with IAC enlargement and the bony defect of IAC fundus, 19 ears (79.2%) were accompanied with dysplasia in the IAC fundus. In all the 24 ears with SFH-Re-IEM, the focal bony defect of the affected stapical footplate and the hemispherical soft-tissue-density herniating cysts protruding into the tympanium were presented on HRCT, and the herniating cysts presenting the cerebrospinal fluid-like signal with the well-defined margin and the ipsilateral normal tympanium were shown on the MRI hydrographic sequence. Two ears underwent the perilymphaticum gadolinium based on MRI, which demonstrated the hypersignal gadolinium in the perilymphatic space entered into the herniating cysts. Two ears were accompanied with the cochlear osseous labyrinthitis.Conclusion:The ears with IEM-Re-SFH usually present the serious hearing loss. The ipsilateral severe IEM, focal bony defect of the stapical footplate and perilymph herniating are characteristic imaging appearances.
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Purpose Papillary thyroid microcarcinoma (PTMC) is difficult to diagnose its nature before surgery, thus results in misdiagnosis. This paper aims to determine the best diagnostic cutoff value using anteroposterior and transverse diameter ratio (A/L) and longitudinal and transverse diameter ration (L/T) in PTMC. Materials and Methods The CT data of 154 pathology proven benign and malignant thyroid nodules ≤ 1.0 cm in diameter in 78 cases were reviewed, including 75 PTMC in 47 patients and 79 benign nodule in 31 patients. The anteroposterior and transverse diameter ratio (A/T) on axial view, A/L on sagittal view, and L/T on coronal view were measured and calculated. A non-parametric method was used to draw the receiver operating curve of A/T, A/L and L/T. The mean and standard deviation of CT diameters in benign and malignant nodules were calculated. The area under the curve, sensitivity, specificity and diagnostic accuracy, positive predictive value and negative predictive value were determined. CT manifestations of small benign and malignant thyroid nodules were also analyzed. Results The A/T and A/L ratio were significantly larger for PTMC than benign nodules (P<0.01), while L/T diameters were significantly smaller than the benign nodules (P<0.01). The area under ROC was 0.8841, 0.7676 and 0.4052 for A/T, A/L and L/T respectively. The best diagnostic cutoff value of A/T and A/L were 1.05 and 1.0. With A/T ≥ 1.05, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.00%, 84.81%, 86.36%, 84.62% and 88.12%, respectively. With A/L ≥ 1.0, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 66.67%, 82.28%, 74.68%, 78.13% and 72.22%, respectively. CT characteristics of PTMC included superficial location, oval low density, blurry boundary, microcalcification and progressive enhancement with accuracy of 71.43%, 50.00%, 79.22%, 68.83% and 90.91%, respectively. Conclusion The cutoff values of A/T ≥ 1.05 and A/L ≥ 1.0 can be used to diagnose PTMC with high accuracy.
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OBJECTIVE@#To evaluate the relationship between human papilloma virus (HPV) infection and the occurrence, recurrence and malignant transformation of nasal inverted papilloma (NIP).@*METHOD@#With comprehensive retrieval of related literature that had been published in databases included Pubmed (1990--2011), Cochrane Library, CNKI (1979-2011), VIP (1989-2011), CBM (1990-2011) and WANFANG Meta-analysis software Rev-Man 5.0 was used to analyze the raw data and to calculate the value of combined odd ratio (OR) and 95% confidence interval (CI).@*RESULT@#According to Meta-analysis, the occurrence group between HPV and NIP, the OR was 34.44 and 95% CI was 12.96-91.56; the recurrence group, the OR was 3.66 and 95% CI was 1.77-7.56, to the high-risk HPV, the OR was 1.94 and 95% CI was 0.30-12.58; the malignant transformation group, the OR was 1.79 and 95% CI was 0.94-3.40 to the high-risk HPV, the OR was 49.35 and 95% (CI was 0.45-11.23.@*CONCLUSION@#HPV may play an important role in the occurrence and recurrence of NIP and high-risk HPV was closely related to the progress of NIP.