[Clinical evaluation of true and false positive Z values among high-risk cases screened by non-invasive prenatal testing].

OBJECTIVE: To analyze the Z values of true and false positive cases by non-invasive prenatal testing (NIPT) in order to improve its accuracy in clinical practice. METHODS: Results of 24 384 NIPT tests were reviewed. For cases with high risks for trisomies 21, 18 and 13, the range of Z values in true and false positive cases was analyzed and discussed. RESULTS: A total of 335 high-risk cases were identified by NIPT, among which 256 had elected prenatal diagnosis, 153 (59.77%) were verified as true positives, and 103 (40.23%) were false positives, and the area under the curve (AUC) was 0.9994. For NIPT screening, the positive predictive value (PPV) for trisomy 21 was 100% when Z>13, regardless if the pregnant woman was over 35. When 335 and about 41.6% (5/12) for those<35. For trisomy 18, the PPV was 100% when Z>13, and only 14.3% (1/7) when 3

Analysis of diagnostic characteristics and clinical related factors of 70 patients with atelectasis by painless bronchoscopy.

Objectives: To analyze the diagnostic characteristics and clinical related factors of patients with atelectasis by painless electronic bronchoscopy. Methods: A retrospective analysis was performed on 70 patients with atelectasis admitted to Xuancheng People's Hospital from April 2019 to June 2021. The clinical data of the patients and the diagnosis characteristics under painless electronic bronchoscope were analyzed, and the clinical related factors were investigated. Results: Seventy patients with atelectasis underwent pathological examination and bacteriological examination after painless electronic bronchoscopy, including 16 cases (22.86%) of inflammation, 11 cases (15.71%) of tuberculosis, 36 cases (51.43%) of tumor, one case (1.43%) of inflammatory polyp, one case (1.43%) of congenital dysplasia, two cases (2.86%) of foreign body inhalation, and three cases (4.29%) of other symptoms. Male patients with atelectasis showed most cauliflower-like tumors and mucosal swelling under electronic bronchoscopy (P<0.05), while female patients showed scar occlusion/stenosis at most (P<0.05). Middle-aged and elderly patients under electronic bronchoscopy showed most cauliflower-like tumors, scar stenosis/occlusion and mucosal swelling cavity, while young patients mainly showed necrosis and purulent secretions. Heavy smokers were most likely to have cauliflower-like tumors, while non-smokers were predominantly with scar stenosis/occlusion. Conclusions: Painless electronic bronchoscopy is of great value in the clinical diagnosis of patients with atelectasis, and it is likely to further clarify the etiology of atelectasis. Age, sex, and quantity of smoking may be clinical factors associated with atelectasis.

Sensitivity of PCR analysis (melting curve method) in diagnosis of Pulmonary Tuberculosis (PTB) based on Bronchoalveolar Lavage (BAL) by bronchoscope.

Objectives: To evaluate the sensitivity of the real-time PCR assay melting curve method in the diagnosis of pulmonary tuberculosis (PTB) by analyzing bronchoalveolar lavage fluid (BALF) obtained from bronchoscopy. Methods: A total of 214 PTB patients who were treated at Xuancheng People's Hospital respiratory and infection department during January 2018 to January 2021 were included in this study. Bronchoscopic bronchoalveolar lavage fluid (BALF) examined by polymerase chain reaction (melting curve method), BALF smear, BALF culture, lipoarabinomannan (LAM) antigen test for diagnosis of tuberculosis (TB) (LAM-TB), acid-fast stain (AFS), and serum adenosine deaminase (ADA) test were conducted respectively to compare their positive predictive values (PPVs). Results: Of the 214 patients with confirmed PTB, 84.11% were BALF melting curve method positive, significantly higher than the positive results yielded by other PTB screening tests, i.e., LAM-TB (69.16%), AFS (51.87%), ADA (49.07%), BALF culture (62.15%), and BALF smear (41.12%) (p<0.05, respectively). The PPVs were increased to 92.06%, 93.93%, 92.99%, 95.79%, and 91.12% when BALF melting curve method was performed in combination with LAM-TB, AFS, ADA, BALF culture, and BALF smear, respectively, significantly higher than that produced by BALF melting curve method or the combined use of any two of the non-BALF melting curve method tests (p<0.05, respectively). Conclusion: BALF melting curve method is an ideal diagnostic approach to PTB, which is of a higher diagnostic value compared with LAM-TB, AFS, ADA, BALF culture, and BALF smear.

[Dynamic changes of LDH and HBDH activity in rabbit serum after low voltage electrical injury].

OBJECTIVE: To investigate changes of LDH and HBDH activity in rabbit serum after non-thermal low voltage electrical injury and to provide diagnostic criteria for non-thermal low voltage electrical injury. METHODS: Forty New Zealand rabbits were randomly distributed into control group and electrical injury group (EI-groups; designated 7 time points: 0 h, 2 h, 4 h, 12 h, 1 d, 2 d, 3 d), 5 rabbits per each group. EI-groups were treated with the method of non-thermal low voltage electrical injury established in our laboratory. Ventricular blood (5 mL) was obtained under anesthesia at designated time points after electrical injury. The activities of LDH and HBDH were measured. RESULTS: Dynamic changes were observed with certain patterns from target serum enzyme activities after electrical injury. Compared with control group, the activities of LDH increased markedly at 4 h, 12 h, and on days 1, 2, and 3 after injury (4 h, 12 h, and day 1 P<0.01; day 2 and day 3 P<0.05). Activities of HBDH increased markedly at day 2 and day 3 after injury (P<0.05). The ratio of HBDH/LDH decreased markedly at 2 h, 4 h, and 12 h after injury (P<0.01). CONCLUSION: Dynamic changes of LDH and HBDH activities may be useful in diagnosis of non-thermal low voltage electrical injury and in estimation of post injury intervals.