Development of an LCD-Based Visual Field System

BACKGROUND: The present study investigated the diagnostic effectiveness of an LCD-based visual field testing system (LVF) in comparison with the standard automated perimetry Humphrey Field Analyzer II-750i (HFA). METHODS: A randomized controlled crossover study was conducted with 202 normal and 128 glaucomatous eyes using both LVF and HFA. The visual field testing systems were compared in terms of mean deviation (MD), pattern standard deviation (PSD), and area under the receiver operating characteristics curve (AUC) of MD and PSD differentiating the normal and glaucomatous eyes. RESULTS: Significant correlations were found between MD measurements from LVF and those from HFA for normal eyes (r = 0.342) and glaucomatous eyes (r = 0.796); slightly higher significant correlations were identified between PSD measurements from LVF and those from HFA for normal eyes (r = 0.363) and glaucomatous eyes (r = 0.828). Furthermore, high AUCs of MD were found as 0.786 for LVF and 0.868 for HFA and AUCs of PSD as 0.913 for LVF and 0.932 for HFA. CONCLUSION: The comparison results of the present study support the competence of LVF compared with HFA in visual field testing for early detection of glaucoma.

Relationship between levels of plasma coagulation factors and acute myocardial infarction in low age period / 重庆医学

Objective To explore the relationship between the levels of plasma coagulation factors (F) and acute myocardial infarction (AMI) in low age period (0.05).The multivariate analysis indicated that the FⅡ level≥ 14.27 μg/L and FⅦ level ≥22.99 μg/L were the independent risk factors for low age AMI.The value of FⅡ for diagnosing low age AMI was lower,and the optimal cut off value of Fg for diagnosing low age AMI was 22.99 μg/L,its area under ROC curve was 0.709 with a moderate diagnostic value,and the sensitivity (91.88%) and negative predictive value (86.02%) were higher,the false negative rate (13.98%) was lower,and the accuracy (70.94%) was moderate.Conclusion The FⅡ level ≥14.27 μg/L and Fg level ≥22.99 μg/L are the independent risk factors for low age AMI,and detecting the Fg level could have hint significance in diagnosing low age AMI.

Morphological and Hemodynamic Parameters for Middle Cerebral Artery Bifurcation Aneurysm Rupture Risk Assessment

OBJECTIVE: To investigate the morphological and hemodynamic parameters associated with middle cerebral artery (MCA)bifurcation aneurysm rupture. METHODS: A retrospective study of 67 consecutive patients was carried out based on 3D digital subtraction angiography data. Morphological and hemodynamic parameters including aneurysm size parameters (dome width, height, and perpendicular height), longest dimension from the aneurysm neck to the dome tip, neck width, aneurysm area, aspect ratio, Longest dimension from the aneurysm neck to the dome tip (Dmax) to dome width, and height-width, Bottleneck factor, as well as wall shear stress (WSS), low WSS area (LSA), percentage of LSA (LSA%) and energy loss (EL) were estimated. Parameters between ruptured and un-ruptured groups were analyzed. Receiver operating characteristics were generated to check prediction performance of all significant variables. RESULTS: Sixty-seven patients with MCA bifurcation aneurysm were included (31 unruptured, 36 ruptured). Dmax (p=0.008) was greater in ruptured group than that in un-ruptured group. D/W (p<0.001) and the percentage of the low WSS area (0.09±0.13 vs. 0.01±0.03, p<0.001) were also greater in the ruptured group. Moreover, the EL in ruptured group was higher than that in un-ruptured group (6.39±5.04 vs. 1.53±0.86, p<0.001). Multivariate regression analysis suggested D/W and EL were significant predictors of rupture of MCA bifurcation aneurysms. Correlation analyses revealed the D/W value was positively associated with the EL (R=0.442, p<0.01). CONCLUSION: D/W and EL might be the most two favorable factors to predict rupture risk of MCA bifurcation aneurysms.

The use of Charlson weighted index to evaluate the time of observation in emergency internal observation room / 中华急诊医学杂志

Objective To investigate the role of underlying diseases in predicting the length of stay for observation in emergency department of internal medicine by the Charlson weighted index of comorbidities (WIC).Methods A single-center retrospective analysis of clinical data of 2 836 patients admitted in emergency observation room of the Beijing Chaoyang Hospital from January 1 to June 30 in 2013 was carried out.The patients were divided into two groups according to the length of observation time:Group A (time of observation ≥72 h,n =1908) and Group B (time of observation ＜ 72 h,n =928).The data of the length of observation time were recorded,and the WIC and the APACHE Ⅱ score were calculated.Logistic regression analysis was used to determine the independent predictors for 72-hour observation.Receiver operating characteristics (ROC) curve was used to evaluate the value of WIC in predicting 72-hour observation.Results Of 2836 patients,1176 (41.5％) suffered from respiratory disease,709 (25.0％) had cardiovascular and cerebrovascular diseases,423 (14.9％) were contracted digestive system disease,251 (8.8％) had renal and endocrinology system diseases and 277 (9.8％) had diseases arisen from physicochemical factor and miscellaneous causes.Compared with patients in Group B,the average age,the number of elderly patients residing in apartment exclusively for elderly,the WIC and the APACHE Ⅱ score were higher in patients in Group A.The one-variable and multi-variable Logistic regression analyses showed that age,the WIC score,the APACHE Ⅱ score and residing in apartment for elderly people were related with 72-hour observation in emergency observation room.The area under the ROC curve in predicting 72-hour observation was 0.701 for the WIC score,0.788 for APACHE Ⅱ score and 0.853 for their combination.Conclusions The WIC scoring system can be a good predicting method for 72-hour observation in patients in emergency observation room.

Prediction of Charlson weighted index of comorbidities on evaluating common diseases on ＞ 60 years old patients with rectum cancer / 中国综合临床

Objective To investigate the effect of common diseases by the Charlson weighted index of comorbidities(WIC) in predicting 1-year survival rate of older patients with rectum cancer.Methods Retrospective analyzed 160 patients with rectum cancer who were admitted in general surgery of Beijing Chaoyang Hospital Affiliated to Capital Medical University from Jun.2011 to May 2012.The patients were divided into two groups according to 1-year survival status:survival group (n =123) and death group (n =37).The data were recorded including age,gender,cancer diagnosis,underlying diseases,operation mode (laparoscopic or open) The WIC and the Acute physiology and chronic health Ⅱ (APACHE Ⅱ) score were calculated.Logistic regression analysis was used to determine the independent predictors for 1-year survival rate.Receiver operating characteristics(ROC) curve was used to evaluate the value of WIC in predicting 1-year survival rate.Results Of the 160 patients,123 cases survived,37 cases died at 1 year after treatment.WIC score and APACHE score in death group were (2.2 ± 1.3) and (11.5 ± 5.1),higher than those of survival group (1.3 ± 1.2,9.5 ± 4.3 ;P =0.021,0.014).Multivariate Logistic regression analysis indicated that age,mode of operation,WIC score and APACHE score were related to the 1-year survival status of patients with rectal cancer(OR(95％ CI):1.053 (1.018-1.178,1.021 (1.011-1.906),1.786 (1.203-2.235),1.019 (1.004-1.628).ROC curve area of forecasting of death of the WIC score,APACHE Ⅱ score and the combination of the two are 0.731,0.828,0.959.Conclusion The WIC scoring system can be a good evaluation method for 1-year survival rate in old patients with rectum cancer.

Clinical value of tumour markers and serum-ascites albumin gradient in diagnosis of malignant ascites / 中华消化杂志

Objective To investigate the clinical value of tumour markers and serum-ascites albumin gradient (SAAG) in diagnosis of malignant ascites. Methods One hundred and fourteen patients with ascites, who were admitted to the hospital between Jan. 2005 and Jan. 2008, were retrospectively reviewed. The patients were divided into malignant (n = 39) or benign (12 with tuberculosis and 93 with aseptic liver cirrhosis) ascites groups according to the etiology. The distribution of tumor markers (CEA, CA19-9 and CA125) and SAAG in both groups were analyzed and receiver operating characteristic (ROC) was constructed. Results The tumor markers and SAAG were found both in malignant ascites group and benign ascites group. The concentrations of CEA and CA19-9 in serum and ascites were higher in malignant ascites group than in benign ascites group. The SAAG in malignant ascites group was significantly lower than that in patients with liver cirrhosis (P<0.05), but had no difference in comparison with tuberculosis patients (P>0. 05). There was no difference in level of CA125 in serum or ascites between malignant ascites group and benign ascites group (P>0.05). The area under the curve of ascitic fluid CEA, CA19-9 and SAAG were 0.79, 0.82 and 0.85, respectively. The cutoff values of ascitic fluid CEA, CA19-9 and SAAG were optimally chosen at 1.45 μ/L, 19.50 μ/L and 13. 50 g/L, respectively. The sensitivity and specificity were 66.7% and 78.1% in CEA, 74.4% and 84.8% in CA19-9, as well as 82.9% and 84.6% in SAAG.The combination of ascitic fluid CA19-9 with SAAG could increase the specificity to 97.14%, but decrease the sensitivity to 61.54%. Conclusion It is feasible to achieve optimum combination of biochemical indicators using ROC in differential diagnosis of malignant ascites from benign ascites.

The clinicam value of serum connective growth tissue factor(CTGF) in the assessment of liver fibrosis / 中国生化药物杂志

Purpose To explore the relationship between connective growth tissue factor(CTGF) in serum and the severity of liver fibrosis,and to determine the clinical value of CTGF in the assessment of liver fibrosis.Methods Serums CTGF were tested utilizing enzyme linked immunosorbent assay(ELISA).The correlation between serum CTGF concentration and fibrosis stage was assessed.Results The diagnostic performance of CTGF was assessed by comparing the area under receiver characteristic curves(AUC) with a panel of fibrosis markers.Correlation coefficient was 0.689(P＜0.001) between the levels of serum CTGF and fibrosis stages and AUC of CTGF was 0.841(95% confidence interval,0.762-0.920) in distinguishing mild fibrosis from significant fibrosis.Conclusion The present data revealed that serum CTGF was significantly correlated with the stage of liver fibrosis,suggesting that serum CTGF was an indicator for the stage of liver fibrosis,and serum CTGF could be used as a valuable marker assessing liver fibrosis.