The value of laparoscopy in the diagnosis and treatment of abdominoscrotal hydrocele / 中华泌尿外科杂志

Abdominoscrotal hydrocele is rare in clinic. In the past, routine examination and diagnosis were difficult, easy to be misdiagnosed. The daily operations were mostly completed through the groin area or abdominal incision, the wound is large. The application of laparoscopy can clearly diagnose the abdominoscrotal hydrocele through "springing back ball" sign, and can cure the disease by laparoscopic resection of interperitoneal mass and closure of the internal ring. It is worthy of clinical application. In this article, we summarized and analyzed the clinical experience of 15 cases of children with abdominoscrotal hydrocele diagnosed and treated by laparoscopy, to explore the value of the laparoscopic technology in the diagnosis and treatment of the abdominoscrotal hydrocele.

Noninvasive models in diagnosis of liver fibrosis in patients with chronic hepatitis B / 中华临床感染病杂志

Objective To compare different noninvasive models in diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB).Methods A total of 838 CHB patients admitted in Shenyang Sixth People’ s Hospital during March 2003 and October 2013 were enrolled in the study.All the patients received liver biopsy, blood and ultrasound examinations; the AST-to-ALT ratio ( AAR), AST to platelet ratio index ( APRI) , age platelet index ( API) , cirrhosis discriminant score ( CDS) , spleen to platelet ratio index ( SPRI) and age-spleen to platelet ratio index ( ASPRI) were obtained.Area under receiver operating characteristic curve (AUROC) was used to assess the clinical value of noninvasive models in diagnosis of significant liver fibrosis (S2-4), advanced liver fibrosis (S3-4) and early liver cirrhosis (S4).Results Among six noninvasive models, APRI had the lowest value of AUROCs ( <0.7), while ASPRI had the highest AUROCs value in diagnosis of liver fibrosis.The AUROCs of ASPRI in diagnosing significant liver fibrosis, advanced liver fibrosis and early liver cirrhosis were 0.861, 0.873 and 0.881 with the sensitivities of 69.4%, 76.9%and 87.0%, the specificities of 87.9%, 81.5% and 75.8%, the positive predictive values of 90.9%, 74.9%and 46.1%and the negative predictive values of 62.2%, 83.1%and 96.1%, respectively.Taking<5.2 and≥9.7 as the cut-off values for exclude significant liver fibrosis and diagnosis of significant liver fibrosis, respectively, 49.4%(414/838) of the patients may avoid liver biopsy with an accuracy of 92.3%(382/414).Conclusion ASPRI is of value in diagnosing significant liver fibrosis and early liver cirrhosis in patient with chronic hepatitis B, and the number of liver biopsy can be reduced.