RÉSUMÉ
Objective To systematically evaluate the application value of next-generation sequencing technology in the etiological diagnosis of patients with sepsis.Methods Databases such as PubMed,Embase,Web of Science,The Cochrane Library,VIP,CNKI,WanFang Data Knowledge Service platform and SinoMed were searched from January 2018 to September 2022.The positive rate of sepsis detection,pathogen detection time,virus detection rate,28 days mortality rate and length of stay in intensive care unit(ICU)were com-pared between next-generation sequencing technology and traditional etiological detection method.Meta-analysis was performed using Review Manager 5.4.1 software,and funnel plot was pictured to analyze the publication bias of the included literatures.Results A total of 18 literatures were included.The results of Meta-analysis showed that the positive rate of next-generation sequencing group was 72.3％(1403/1941),which was significantly higher than that of the traditional etiological detection group[28.4％(556/1958),OR=7.03,95％CI:4.52-10.95,P＜0.01];the time of pathogen detection was significantly lower than that of traditional etiological detec-tion group(OR=-34.22,95％CI:-41.95--26.48,P＜0.01);the virus detection rate was significantly higher than that of tradi-tional etiological detection group(OR=57.82,95％CI:19.27-173.46,P＜0.01);the length of stay in ICU was significantly lower than that of traditional etiological detection group(WMD=-9.37,95％CI:-16.28--2.46,P＜0.01);there was no significant difference in 28 days mortality between the two groups(OR=0.43,95％CI:0.02-8.47,P=0.58).Conclusion Compared with tra-ditional etiological detection methods,next-generation sequencing technology can improve the positive rate of pathogen detection and vi-rus detection in sepsis patients,shorten the time of pathogen physical examination and the length of stay in ICU,and has higher applica-tion value for the diagnosis and treatment of sepsis.
RÉSUMÉ
Objective To evaluate the clinical value of 18F-FDG PET/CT in the detection of residual,recurrent and metastatic diseases in post-treatment uterine cervical cancer patients presenting with elevated serum squamous cell carcinoma (SCC) antigen levels.Methods Between March 2009 and October 2012,18F-FDG PET/CT was performed in 48 patients(average age (47.5±11.2) years) with suspected residual,recurrent or metastatic uterine cervical cancer because of increased serum SCC antigen level (＞1.5 tμg/L).The final diagnosis was established by pathology or more than 1 year of clinical follow-up.The diagnostic efficiency of 18F-FDG PET/CT was calculated.Two-sample t test was used for data analysis.Results The serum SCC levels were 1.6-42.5(mean:8.6±9.4) μg/L.Among the 48 patients,45 (93.75％) were confirmed of having malignant lesions.18F-FDG PET/CT along with other imaging detected 174 lesions,of which 169 were proven as residual,recurrent or metastatic diseases.18F-FDG PET/CT correctly identified 159 lesions,yielding a diagnostic sensitivity and accuracy of 94.08％(159/169) and 91.38％(159/174),respectively.The diagnostic sensitivity and accuracy for residual and recurrent diseases were both 9/10;for lymph node metastasis were 94.59％ (105/111) and 92.92％ (105/113),respectively;and for other sites of metastasis were 93.75％ (45/48) and 88.24％ (45/51),respectively.There was no significant difference of SUVmax between the patients with residual/recurrent disease (mean:6.9±3.8,range:2.0-13.7) and those with metastasis (mean:6.3±2.7,range:2.0-14.4,t=0.629,P＞0.05).Conclusion 18F-FDG PET/CT is valuable for the detection of residual,recurrent and metastatic diseases in the uterine cervical cancer patients pr esenting with elevated serum squamous cell carcinoma antigen after conventional treatment.