Diagnostic value of plasma SPINK4 expression in colorectal adenocarcinoma and progressive adenoma / 重庆医学

Objective To investigate the clinical diagnostic value of plasma serine protease inhibitor Ka-zal-type 4(SPINK4)expression in colorectal adenocarcinoma(CRC)and progressive adenoma(AA).Methods A total of 62 patients with CRC(CRC group)and 15 patients with AA(AA group)diagnosed by colonoscopy and pathological examination in this hospital from June 2020 to December 2021 were selected,and 22 healthy people undergoing physical examination during the same period were selected as the HC group.The expression of SPINK4 in plasma was detected by ELISA,and the expression of CEA in plasma was detected by electrochemiluminescence,and the correlation was analyzed.The diagnostic efficiency was analyzed by re-ceiver operating characteristic(ROC)curve,and the expression of p53 in CRC tissues was detected by immu-nohistochemistry.Results The expression of plasma SPINK4 in the CRC group and AA group was lower than that in the HC group(Z=3.72,-0.41,P＜0.05),and the expression of CEA in the CRC group was higher than that in the HC group(Z=-3.63,P＜0.05).The area under the curve(AUC),accuracy,sensi-tivity and specificity of SPINK4 combined with CEA in the diagnosis of CRC and AA were higher than those of SPINK4 and CEA alone.The positive rate of mutant type p53 in SPINK4 low expression group and CEA high ex-pression group was significantly increased in CRC patients(72.55％,75.00％,P＜0.05).Conclusion The expression of plasma SPINK4 is decreased in CRC and AA,and the combined detection of SPINK4 and CEA has a good di-agnostic efficiency in CRC and AA.

Study on Variation Trend of Pre-treatment Blood Human Chorionic Gonadotropin in Predicting Efficacy of Tubal Pregnancy Treated by Drug Therapy / 广州中医药大学学报

Objective To investigate the role of variation trend of pre-treatment blood beta human chorionic gonadotropin(β-HCG)in predicting the efficacy of tubal pregnancy(TP)treated by drug therapy.Methods Clinical data of 380 TP patients treated by drug therapy at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2017 to June 2022 were collected.The patients were divided into 271 cases in the pure Chinese medicine(CM)treatment group(shortened as pure CM group)and 109 cases in the combination of Chinese medicine and western medicine group(shortened as combination group)according to the therapy.The relevant factors that may affect the outcomes of the therapy were analyzed,and logistic regression analysis was used for the control of confounding factors.The influences of pre-treatment β-HCG on the outcomes of TP treated by various therapies were investigated,and the value of variation trend of pre-treatment β-HCG in predicting the efficacy of TP treated by drug therapy was assessed using the receiver operating characteristic curve(ROC curve).Results(1)The results of univariate analysis showed that the initial value of blood β-HCG,the variation trend of β-HCG and the difference value of β-HCG detected for 2 times before treatment were correlated with the treatment outcomes in the pure CM group and the combination group,and the differences were all statistically significant(P＜0.05 or P＜0.01).(2)The results of multivariate regression analysis showed that in the pure CM group,the blood β-HCG values and the variation trend of β-HCG detected for 2 times before treatment were correlated with the treatment outcomes,and the differences were all statistically significant(P＜0.05 or P＜0.01);in the combination group,the menopausal time and blood β-HCG value detected at the second time before treatment were correlated with the treatment outcomes,and the differences were all statistically significant(P＜0.05).(3)After controlling for the confounding factors,the variation trend of pre-treatment β-HCG in the pure CM group was correlated with the treatment outcomes,and the difference was statistically significant(OR=3.35,95%CI being 1.69-6.65,P = 0.001).However,the variation trend of pre-treatment β-HCG in the combination group did not affect the treatment outcomes,and the difference was not statistically significant(P＞0.05).(4)The ROC curve analysis showed that the area under the curve(AUC)in the pure CM group was 0.74,the cutoff value was-0.14,the sensitivity was 71.3%and the specificity was 67.8%.The AUC in the combination group was 0.67,the cutoff value was 0.10,the sensitivity was 73.6%and the specificity was 60.7%.Conclusion The variation trend of pre-treatment blood β-HCG can effectively predict the efficacy of Chinese medicine for the treatment of TP,but has no value for predicting the efficacy of the combination of Chinese medicine and western medicine in treating TP.The variation value of pre-treatment blood β-HCG can be used as a valuable reference indicator for the early prediction of the outcomes of TP treated by drug therapy.

Clinical Prediction Model for Diabetic Kidney Disease Based on Optical Coherence Tomography Angiography / 中山大学学报(医学科学版)

ObjectiveTo construct and validate a clinical prediction model for diabetic kidney disease （DKD） based on optical coherence tomography angiography （OCTA）. MethodsThis study enrolled 567 diabetes patients. The random forest algorithm as well as logistic regression analysis were applied to construct the prediction model. The model discrimination and clinical usefulness were evaluated by receiver operating characteristic curve （ROC） and decision curve analysis （DCA）， respectively. ResultsThe clinical prediction model for DKD based on OCTA was constructed with area under the curve （AUC） of 0.878 and Brier score of 0.11. ConclusionsThrough multidimensional verification， the clinical prediction nomogram model based on OCTA allowed for early warning and advanced intervention of DKD.

Preliminary application of artificial intelligence in the pathological diagnosis of periapical cysts / 口腔疾病防治

Objective@#To study the effect of artificial intelligence in the pathological diagnosis of periapical cysts and to explore the application of artificial intelligence in the field of oral pathology.@*Methods@#Pathological images of eighty-seven periapical cysts were selected as subjects to read, and a neural network with a U-net structure was constructed. The 87 HE images and labeled images of periapical cysts were divided into a training set (72 images) and a test set (15 images), which were used in the training model and test model, respectively. Finally, the target level index F1 score, pixel level index Dice coefficient and receiver operating characteristic (ROC) curve were used to evaluate the ability of the U-net model to recognize periapical cyst epithelium.@*Results @# The F1 score of the U-net network model for recognizing periapical cyst epithelium was 0.75, and the Dice index and the areas under the ROC curve were 0.685 and 0.878, respectively.@*Conclusion@#The U-net network model constructed by artificial intelligence has a good segmentation result in identifying periapical cyst epithelium, which can be preliminarily applied in the pathological diagnosis of periapical cysts and is expected to be gradually popularized in clinical practice after further verification with large samples.

Study on the sensitivity of a volumetric modulated arc therapy plan verification equipment on multi-leaf collimator opening and closing errors and its gamma pass rate limit / 生物医学工程学杂志

To investigate the γ pass rate limit of plan verification equipment for volumetric modulated arc therapy (VMAT) plan verification and its sensitivity on the opening and closing errors of multi-leaf collimator (MLC), 50 cases of nasopharyngeal carcinoma VMAT plan with clockwise and counterclockwise full arcs were randomly selected. Eight kinds of MLC opening and closing errors were introduced in 10 cases of them, and 80 plans with errors were generated. Firstly, the plan verification was conducted in the form of field-by-field measurement and true composite measurement. The γ analysis with the criteria of 3% dose difference, distance to agreement of 2 mm, 10% dose threshold, and absolute dose global normalized conditions were performed for these fields. Then gradient analysis was used to investigate the sensitivity of field-by-field measurement and true composite measurement on MLC opening and closing errors, and the receiver operating characteristic curve (ROC) was used to investigate the optimal threshold of γ pass rate for identifying errors. Tolerance limits and action limits for γ pass rates were calculated using statistical process control (SPC) method for another 40 cases. The error identification ability using the tolerance limit calculated by SPC method and the universal tolerance limit (95%) were compared with using the optimal threshold of ROC. The results show that for the true composite measurement, the clockwise arc and the counterclockwise arc, the descent gradients of the γ passing rate with per millimeter MLC opening error are 10.61%, 7.62% and 6.66%, respectively, and the descent gradients with per millimeter MLC closing error are 9.75%, 7.36% and 6.37%, respectively. The optimal thresholds obtained by the ROC method are 99.35%, 97.95% and 98.25%, respectively, and the tolerance limits obtained by the SPC method are 98.98%, 97.74% and 98.62%, respectively. The tolerance limit calculated by SPC method is close to the optimal threshold of ROC, both of which could identify all errors of ±2 mm, while the universal tolerance limit can only partially identify them, indicating that the universal tolerance limit is not sensitive on some large errors. Therefore, considering the factors such as ease of use and accuracy, it is suggested to use the true composite measurement in clinical practice, and to formulate tolerance limits and action limits suitable for the actual process of the institution based on the SPC method. In conclusion, it is expected that the results of this study can provide some references for institutions to optimize the radiotherapy plan verification process, set appropriate pass rate limit, and promote the standardization of plan verification.

Expression and meaning of CHSTs family in clinical non-functioning adenomas / 重庆医学

Objective To observe the RNA expression level of carbohydrate thiotransferase family(CHSTs)in non-functioning adenoma,and to analyze its clinical significance.Methods Ninety tissue samples of clinical non-functioning adenoma were collected.The mRNA expression levels of CHST1/2/7/8,follicle-stimulating hormone subunit(3(FSHb),POU domain transcription factor 1(POU1F1)and steroid-producing factor 1(SF-1)were detected by real time fluorescence quantitative PCR(RT-qPCR).And receiver operating characteristic(ROC)curve was used to screen the CHST molecule possessing the function for diagnosing CHST molecule differentiated by non-functional adenoma lineage.Results The expression amounts of CHST1 gene and CHST7 gene in the tumors with large volume were higher than those with small tumors(P=0.014,P=0.044),and the CHST2 gene level in female patients was higher than that in male patients(P=0.016),and the CHST8 gene level in invasive tumors were lower than in non-invasive tumors(P=0.044).The grouping was conducted according to the intensity of SF-1 staining,there were statistically signif-icant differences in CHST1/2/7/8 gene levels among all groups(P＜0.05);the grouping was performed ac-cording to the intensity of PIT1 staining,there were statistically significant differences in CHST1/7 gene levels among all groups(P＜0.01).The correlation analysis showed that the CHST1 level was positively correlated with the tumor volume and POU1F1 level(r=0.322,P=0.002;r=0.686,P＜0.001)and negatively corre-lated with the NR5A1 level(r=-0.227,P=0.032).The CHST7 level was positively correlated with the POU1F1 level(r=0.774,P＜0.001);the CHST8 level was positively correlated with the FSHb and NR5A1 levels(r=0.485,P＜0.001;r=0.725,P＜0.001).The area under ROC curve(AUC)of CHST1 for diagno-sing the immature POU1F1 lineage was 0.750(P=0.023).AUC of CHST8 for diagnosing SF-1 lineage was 0.776(P=0.008),and the AUC of CHST1 combined with CHST8 was 0.823(P=0.002).Conclusion The CHST family is involved in the proliferation and differentiation of clinical nonfunctional adenomas.CHST1 combined with CHST8 is valuable in the diagnosis of SF-1 lineage differentiation.

Association between triglyceride glucose index and its related derivative index and metabolic associated fatty liver disease in the elderly men / 解放军医学杂志

Objective To explore the association between triglyceride glucose(TyG)index and TyG-body mass index(TyG-BMI)and the prevalence of metabolic associated fatty liver disease(MAFLD)in the elderly men.Methods Totally 2290 elderly men were selected from January to December in 2021 in the Second Medical Center of Chinese PLA General Hospital,and divided into MAFLD group(n=1322)and non-MAFLD group(n=968).Multivariate logistic regression was used to analyze the association between TyG index,TyG-BMI and MAFLD.The receiver operating characteristic(ROC)curve was drawn to explore the predictive value of TyG index and TyG-BMI with MAFLD in the elderly men.Results Two thousand two hundred and ninety elderly men were(74.3±10.1)years old,and an average BMI of(24.63±2.70)kg/m2.BMI,γ-glutamyl transaminase(γ-GT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),the rate of smoking and drinking,and the prevalence of hypertension,diabetes,hyperuricemia,high triglyceride(TG),low high density lipoprotein cholesterol(HDL-C),hyperuricemia,thyroid nodules and cholelithiasis were all significantly higher in non-MAFLD group than those in MAFLD group(P<0.05),while the age of MAFLD group was lower than that of non-MAFLD group(P=0.003).Multivariate logistic regression analysis showed that the risk of MAFLD in patients of TyG quartile groups Q2,Q3,Q4 was 1.667(95%CI 1.257-2.236,P<0.001),2.004(95%CI 1.482-2.710,P<0.001)and 5.420(95%CI 3.266-8.995,P<0.001)times higher than that of TyG Q1,respectively.The risk of MAFLD in patients of TyG-BMI Q2,Q3,Q4 was 2.215(95%CI 1.549-3.167,P<0.001),2.809(95%CI 1.723-4.580,P<0.001)and 2.513(95%CI 1.253-5.040,P=0.009)times higher than that of TyG-BMI Q1,respectively.The ROC curve showed that areas under the curve(AUC)of MAFLD predicted by TyG index and TyG-BMI were 0.717(95%CI 0.696-0.738)and 0.840(95%CI 0.823-0.856),and the best cut-off values were 8.63 and 205.20,respectively.Moreover,the ROC curve showed that AUC of MAFLD in the elderly men without hyperlipidemia or diabetes predicted by TyG index and TyG-BMI were 0.653(95%CI 0.622-0.684)and 0.840(95%CI 0.818-0.862),and the best cut-off values were 8.42 and 202.66,respectively.In addition,AUC,accuracy,specificity,sensitivity,positive predictive value and negative predictive value predicted by TyG-BMI were higher than those by TyG index.Conclusions TyG index and TyG-BMI are significantly associated with MAFLD in the elderly men.Both TyG index and TyG-BMI have certain predictive value for the prevalence of MAFLD in the elderly men,and TyG-BMI may be better.

Visual function changes of dysthyroid optic neuropathy and ROC curve analysis for early diagnostic indicators / 中南大学学报(医学版)

OBJECTIVES@#Dysthyroid optic neuropathy (DON) is a class of diseases that makes seriously endanger to the vision of patients with thyroid-associated ophthalmopathy. This study aims to observe the visual function changes in patients with DON, and to evaluate the diagnostic value of indicators diagnosing DON.@*METHODS@#A retrospective study was conducted on 98 eyes of 49 patients with dysthyroid optic neuropathy (DON) who were treated in Xiangya Hospital of Central South University from January 2017 to December 2019. All patients were received the examination of best corrected visual acuity (BCVA), Humphrey visual field, visual evoked potential (VEP), and contrast sensitivity. Ninety-eight eyes were divided into a DON group (45 eyes) and a non-DON group (53 eyes). T-test was used to compare the related indicators between the 2 groups. The sensitivity and specificity of each indicator were analyzed by receiver operating characteristic (ROC) curve.@*RESULTS@#The BCVA and visual field index (VFI) of the DON group were significantly lower than those of the non-DON group (all P<0.05). The mean deviation (MD) and pattern standard deviation (PSD) of the DON group were significantly higher than those of the non-DON group (all P<0.05). The low frequency contrast sensitivity (CSL), medium frequency contrast sensitivity (CSM), and high frequency contrast sensitivity (CSH) of the DON group were significantly lower than those of the non-DON group (all P<0.05), with CSH being particularly prominent. Compared with the non-DON group, at spatial frequencies of 15°, 30°, and 60°, the amplitude of N135 wave was significantly reduced, and the latency of N75 wave, P100 wave, and N135 wave was significantly prolonged in the DON group (all P<0.05); at spatial frequencies of 15° and 30°, the amplitude of P100 wave was significantly reduced in the DON group (P<0.05). The ROC curve analysis results showed that the area under the curve (AUC) of VFI, CSL, CSM, CSH and 15° P100 amplitude diagnosing DON were 0.812, 0.841, 0.880, 0.784, and 0.791, respectively, with CSM possessing the highest sensitivity and specificity.@*CONCLUSIONS@#The visual function of patients with DON is decreased. VFI, contrast sensitivity of low, medium, and high frequency, and 15° P100 wave amplitude might be effective indicators for early diagnosis of DON.

Analysis on the pharyngeal microbiota in patients with laryngopharyngeal reflux disease

Abstract Objective(s): In this study, the laryngopharynx microbiome alterations were characterized after proton pump inhibitor treatment in patients with Laryngopharyngeal Reflux Disease (LPRD) and healthy people. The potential outcome-predictive biomarker was explored. Methods: Patients with LPRD and healthy controls were enrolled. The composition of their laryngopharynx microbiota was analyzed both by traditional plate count of the main bacterial groups and PCR amplification followed by denaturing gradient gel electrophoresis. Shannon-Wiener index and evenness index based on Dice index were used to assess the bacterial diversity. Droplet digital PCR was used to determine the total bacterial RNA and relative abundance of Klebsiella oxytoca. Receiver operating characteristic curve was plotted to explore the potential of Klebsiella oxytoca as an outcome-predictive biomarker. Results: A total of 29 LPRD cases and 28 healthy subjects were enrolled. The composition of the laryngopharynx microbiota was almost similar, except Klebsiella oxytoca. The cluster analysis showed that the similarity between healthy and treatment-effective groups, as well as pretreatment and treatment-invalid groups, was close. Statistical analysis showed that there were differences in the diversity index and richness among the healthy, treatment-effective, pretreatment and treatment-invalid groups. The abundance of Klebsiella oxytoca in the treatment-effective LPRD group was lower than that of the treatment-invalid LPRD group. The abundance of Klebsiella oxytoca can distinguish treatment-effective and -invalid groups (AUC = 0.859) with a sensitivity of 77.78% and specificity of 90.91%. Conclusion: There were differences in the diversity of cecal contents microbial community between treatment-invalid and treatment-effective LPRD groups. Klebsiella oxytoca has potential to distinguish treatment outcomes. Level of evidence: How common is the problem? Level 1. Is this diagnostic or monitoring test accurate? (Diagnosis) Level 4. What will happen if we do not add a therapy? (Prognosis) Level 5. Does this intervention help? (Treatment Benefits) Level 4. What are the COMMON harms? (Treatment Harms) Level 4. What are the RARE harms? (Treatment Harms) Level 4. Is this (early detection) test worthwhile?(Screening) Level 4.

Clinical characteristics of human cytomegalovirus pneumonia in children and the diagnosis value of detecting human cytomegalovirus DNA in bronchoalveolar lavage fluid / 中国小儿急救医学

Objective:To investigate the clinical features, therapy and prognosis of human cytomegalovirus(HCMV)pneumonia in pediatric patients, and to analyze the diagnosis value of detecting HCMV DNA in bronchoalveolar lavage fluid(BALF)by real-time PCR.Methods:The clinical characteristics of 58 pediatric inpatients who were HCMV DNA positive in BALF were retrospectively reviewed.All the patients were from Shengjing Hospital of China Medical University from January 2015 to December 2019.Clinical, radiologic, laboratory and microbiologic data was collected for each patient.The study cohort was divided into HCMV productive infection and latent infection consisting of 22 and 36 patients respectively, based on the HCMV active infection in lung or not.Receiver operating characteristic(ROC)curve was used to assess utility of detecting HCMV DNA in BALF and establish a threshold for diagnosis.Results:(1)Compared with patients in latent infection group, the children in productive infection group had a lower age of onset( P<0.05), a higher proportion of male( P<0.05), and more prolonged hospitalization stay( P<0.05). Pulmonary rales, hypoxemia and higher AST, CK, LDH in serum were easier to detect in productive infection group( P<0.05). Higher HCMV DNA copies in BALF was also detected( P<0.01). Patients in productive infection group had significantly more exposure to additional oxygen treatment or mechanical ventilation and systemic hormone therapy( P<0.05), while with poorer outcomes( P<0.05). (2) ROC curve analysis showed that the AUC for HCMV DNA in BALF in diagnosis of HCMV pneumonia was 0.708 with a threshold of 8.83×10 3 copies/mL, a sensitivity of 77.27%, and a specificity of 58.33%. Conclusion:Those who are diagnosed HCMV pneumonia have a lower age of onset with higher male proportion.These children suffered severer clinical signs.The patients with HCMV DNA copies higher than 8.83×10 3 copies/mL in BALF would be more likely to be diagnosed as HCMV pneumonia.

Screening of radiation sensitive lipids in rat plasma at early stage after total body irradiation with 60Co γ-rays / 中华放射医学与防护杂志

Objective:To explore the characteristics of lipid metabolism in rat plasma after total body irradiation(TBI) in order to provide scientific evidence of radiation biomarkers.Methods:For the non-targeted lipidomics study, 50 SD rats were divided into 6 groups and irradiated with 0, 1, 2, 3, 5 or 8 Gy 60Co γ-rays, respectively. For the targeted lipidomics study, 25 rats were divided into 5 groups and irradiated with 0, 0.5, 2.5, 4 or 6 Gy. Venous blood samples were collected and plasma were separated 4 h after TBI. Radiation-sensitive lipids were screened and their concentrations were determined. Receiver operating characteristic curve (ROC) and dose-response were analyzed. Results:A total of 15 radiation differential lipids were screened out based on non-targeted lipidomics study and 7 of them were identified as radiosensitive lipids by targeted lipidomics analysis. The ROC of radiosensitive lipids distinguished area under curve (AUC) of samples in 0 Gy group and > 0 Gy group, < 2 Gy group and ≥ 2 Gy group were all > 0.75. The AUC values were increased to 0.96 and 0.94 after the panel of radiation sensitive lipids ROC analysis. The concentrations of LysoPC(18: 2), LysoPC(22: 0), PC(18: 0/18: 2), PE(18: 2/16: 0) and PE(18: 2/18: 0) decreased with irradiation dose within 0-6 Gy.Conclusions:A total of 7 plasma radiosensitive lipids in rat plasma were identified 4 h after TBI, and the panel of them could be used for specific dose classification. Five of the lipids had good dose-response relationship.

Comparison analysis of five ultrasound malignancy risk stratification guidelines for thyroid nodules / 中华超声影像学杂志

Objective:To compare and analyze the clinical diagnostic values of five thyroid nodule malignant risk stratification guidelines.Methods:From October 2019 to October 2021, 926 cases of patients with 1 027 thyroid nodules were recruited in the Second Affiliated Hospital of Xi ′an Jiaotong University. All nodules were categorized individually according to 2015 American Thyroid Association for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults Guidelines(ATA guidelines), 2016 the Korean Society of Radiology and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data Systems(K-TIRADS), 2017 European Thyroid Association Thyroid Imaging Reporting and Data Systems(Eu-TIRADS), 2017 American College of Radiology Thyroid Imaging Reporting and Data Systems (ACR TI-RADS), and 2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS). The pathological results were taken as the gold standard, the malignancy ratio of nodules of different categories in each system was calculated. ROC curves were plotted to evaluate the diagnostic efficiencies of different systems, and DeLong test was used to compare the areas under ROC curves. The sensitivity and specificity of different systems were calculated when the maximum point of the Youden index was the optimal cut-off value.Results:In the same stratified system, there were statistically significant differences in the malignant proportion of nodules of different grades ( P<0.05). The malignant proportion of nodules in the high-risk group showed no significant difference among different stratified systems ( P>0.05). Except for C-TIRADS, the malignant proportion of nodules was increased with the increase of diagnostic grade at each grade of the other four stratification systems. ROC curve showed that AUCs of ATA guidelines, K-TIRADS, EU-TIRADS, ACR TI-RADS and C-TIRADS were 0.814, 0.819, 0.814, 0.820 and 0.802, respectively, there was no statistical significance in AUC of different stratification systems (all P>0.05). The optimal truncation values in differentiating benign and malignant nodules were middle-risk malignant nodules, moderately suspicious malignant nodules, middle-risk malignant nodules, class 4 and class 4B. The diagnostic of five stratification systems showed that ATA guidelines had the highest sensitivity (0.784), C-TIRADS had the highest specificity (0.854). Conclusions:The five stratified systems have similar efficacy in differentiating benign and malignant thyroid nodules, and all of them have good diagnostic value.

Establish deferral criterion for HIV serological testing in blood donors / 中国输血杂志

【Objective】 To establish deferral criterion of HIV ELISA (enzyme-linked immunosorbent assay) and electrochemiluminescence immunoassay(ECLIA) by using receiver operating characteristic curve(ROC) method to screen HIV reactive blood donors suitable for entering the re-entry process and improve the management efficiency of reactive blood donors. 【Methods】 The test results of 92 001 blood donors from February to September 2019 were analyzed, and 177 reactive samples were screened by conventional screening mode (twice ELISA and once nucleic acid), supplemented with electrochemiluminescence immunoassay assay (ECLIA), and confirmed by Western blotting (WB). Screening reactive samples were divided into three groups: group A was both serological and nucleic acid reactivity, group B was only serological reactive, and group C was only nucleic acid reactivity. Its efficacy in blood donor classification was assessed by drawing ROC curves with 99% specific corresponding S/CO low values as the deferral criterion of the corresponding serological method. 【Results】 1) A total of 177 HIV reactive samples were detected in conventional mode, including 34 in group A, 142 in Group B and 1 in Group C. The positive predictive value (PPV) was 100%, 0.75% and 100%, respectively. ECLIA detection mode (once ECLIA and once NAT), a total of 67 HIV reactive samples including 34 in group A, 32 in group B and 1 in group C, with positive predictive values of 100%, 3.7% and 100%, respectively.2) The HIV test results showed diversity, with 36 true positive samples including 1 HIV elite controller and 3 early HIV infections (1 HIV ELISA antigen/antibody window and 2 ELISA HIV antibody window), and 32 serological and NAT cases were reactive infections.3) The deferral limit of ELISA 1 and ELISA 2 in conventional screening mode were 20.25 and 9.85, respectively, can screen 97.14% (34/35) of all true positive samples in group A and B, except for one ELISA HIV antibody window (ELISA 2 reactivity). The positive predictive values were 93.94% and 92.85%, respectively. The ECLIA deferral limit of 7.83 can screens all true positive samples in Groups A and B (35/35)in ECLIA mode. The positive predictive value was 94.59%. 【Conclusion】 The establishment of deferral limits in this study can effectively screen HIV-positive blood donors, and the number of screened blood donors is greatly reduced, which is helpful to fine and scientific management of HIV-reactive blood donors. The deferral limit values of different testing reagents are quite different, so each laboratory should choose appropriate testing methods to establish the deferral limit values suitable for the laboratory according to its own testing ability, so as to provide technical support for optimizing the process of returning blood donors to the team.

Predictive values of ALBI and EZ-ALBI scores for early survival of recipients with liver failure after liver transplantation / 器官移植

Objective To evaluate the predictive values of albumin-bilirubin (ALBI) and easy albumin-bilirubin (EZ-ALBI) scores for early survival (postoperative 3 months) of recipients with liver failure after liver transplantation. Methods Clinical data of 137 recipients diagnosed with liver failure and underwent liver transplantation were retrospectively analyzed. The optimal cut-off values of preoperative ALBI, EZ-ALBI and MELD scores to predict early survival of recipients with liver failure after liver transplantation were determined by the area under the receiver operating characteristic (ROC) curve. The risk factors of early death of recipients with liver failure after liver transplantation were identified by univariate and multivariate Cox regression analyses. The effects of different ALBI and EZ-ALBI levels upon early prognosis of recipients with liver failure after liver transplantation were analyzed. Results The optimal cut-off values of ALBI, EZ-ALBI and MELD scores were 0.21, -19.83 and 24.36, and the AUC was 0.706, 0.697 and 0.686, respectively. Univariate Cox regression analysis showed that preoperative alanine aminotransferase(ALT)≥50 U/L, aspartate aminotransferase(AST)≥60 U/L, ALBI score≥0.21 and EZ-ALBI score≥-19.83 were the risk factors for early postoperative death of recipients with liver failure after liver transplantation (all P < 0.05). Multivariate Cox regression analysis demonstrated that preoperative ALBI score≥0.21 was an independent risk factor for early postoperative death of recipients with liver failure after liver transplantation (P < 0.05). According to the optimal cut-off value of ALBI score, the early survival rates in the ALBI < 0.21 (n=46) and ALBI≥0.21(n=91) groups were 93.5% and 64.8%, and the difference was statistically significant (P < 0.05). According to the optimal cut-off value of EZ-ALBI score, the early survival rates in the EZ-ALBI < -19.83(n=60) and EZ-ALBI≥-19.83(n=77) groups were 88.3% and 63.6%, and the difference was statistically significant (P < 0.05). Conclusions Preoperative ALBI score is of high predictive value for early survival of recipients with liver failure after liver transplantation, which could be utilized as a reference parameter for selecting liver transplant recipients.

The ratio of superior mesenteric artery diameter to superior mesenteric vein diameter based on non-enhanced computed tomography in the early diagnosis of spontaneous isolated superior mesenteric artery dissection / 世界急诊医学杂志（英文）

@#BACKGROUND: Spontaneous isolated superior mesenteric artery (SMA) dissection (SISMAD) is a rare cause of abdominal pain. The aim of the study is to investigate the role of a new parameter, the ratio of the SMA diameter to the superior mesenteric vein (SMV) diameter (SMA/SMV) based on non-enhanced computed tomography (CT), in the early diagnosis of SISMAD. METHODS: In a registry study from December 2013 to June 2021, 97 abdominal pain SISMAD patients (SISMAD group) admitted to our hospital were enrolled. Meanwhile, the matched sex and age abdominal pain non-SISMAD patients at 1:2 were collected in reverse chronological order as the control group. Student's t-test, Wilcoxon rank-sum test, and Chi-square test were used to compare differences between the SISMAD and control groups. MedCalc was used to generate receiver operating characteristic (ROC) curve. RESULTS: A total of 291 abdominal pain patients, including 97 SISMAD patients and 194 non-SISMAD patients, were included in the current study. The maximum SMA diameter, perivascular exudation, and SMA/SMV based on non-enhanced CT were significant between the two groups (all P<0.05). ROC curves showed that for the maximum SMA diameter, the area under the curve (AUC), cut-off, sensitivity, and specificity were 0.926, 9.80, 93.8%, and 79.4%, respectively. For SMA/SMV, its AUC, cut-off, sensitivity, and specificity were 0.956, 0.83, 88.7%, and 92.3%, respectively. The diagnostic efficiency of SMA/SMV was better than that of the maximum SMA diameter (P<0.05). The combined parameters of SMA/SMV and maximum SMA diameter had the best diagnostic efficiency (AUC=0.970). CONCLUSION: SMA/SMV may be a potential marker for SISMAD.

The value of urodynamic study in the differential diagnosis of patients with parkinsonian-type multiple system atrophy and Parkinson′s disease with lower urinary tract symptoms / 中华神经科杂志

Objective:To investigate the urodynamic characteristics in parkinsonian-type multiple system atrophy (MSA-P) and Parkinson′s disease (PD) patients with lower urinary tract symptoms (LUTS) and to identify the differential diagnostic ability of urodynamic study.Methods:Sixty-eight MSA-P patients and 85 PD patients with LUTS who underwent urodynamic studies and were hospitalized in the First Affiliated Hospital of Zhengzhou University from February 2017 to December 2020 were reviewed. The receiver operating characteristic (ROC) curve was used to evaluate the discriminatory power of urodynamic parameters.Results:Compared with PD, patients with MSA-P had shorter disease duration [2.70 (2.05, 3.00) years vs 5.00 (4.00, 6.00) years, Z=-7.44, P<0.001]. In free uroflowmetry (UFM) and pressure-flow study (PFS), patients with MSA-P showed lower maximal flow rate [Qmax; UFM-Qmax 6.00 (3.00, 8.75) ml/s vs 9.00 (6.00, 14.00) ml/s, Z=-4.31, P<0.001; PFS-Qmax[6.00 (3.00, 8.75) ml/s vs 9.00 (6.00, 14.00) ml/s, Z=-4.03, P<0.001] and larger postvoid residual [PVR;UFM-PVR 207.50 (113.75, 280.00) ml vs 45.00 (10.00, 117.50) ml, Z =-6.03, P<0.001; PFS-PVR 269.00 (148.75, 337.50) ml vs 75.00 (20.00, 167.50) ml, Z=-6.55, P<0.001)] with decreased compliance [42.65% (29/68) vs 14.12% (12/85), χ 2=15.68, P<0.001], decreased detrusor pressure at maximun flow rate [PdetQmax; 13.00 (6.00, 27.75) cmH 2O vs 27.00 (15.00, 39.50) cmH 2O, Z=-4.65, P<0.001; 1 cmH 2O=0.098 kPa] and impaired contractility [43.00 (34.00, 59.25) vs 79.00 (46.50, 100.00), Z=-5.44, P<0.001]. Compared with the MSA-P patients, detrusor overactivity (DO) was prominent in PD [54.41% (37/68) vs 78.82% (67/85), χ 2=10.34, P=0.001]. The ROC curve results showed that PFS-PVR had highest area under the curve (AUC), which was 0.81 (95% CI 0.74-0.88, P<0.001), followed by UFM-PVR, bladder contractility index and PdetQmax (0.78, 0.76 and 0.72, respectively). Conclusions:Patients with MSA-P showed lower Qmax and larger PVR with decreased bladder compliance and impaired contractility, while patients with PD had higher incidence of DO. The ROC results showed that PFS-PVR had the highest AUC and specificity in the differential diagnosis of MSA-P and PD,indicating that urodynamic study is a useful tool in differential diagnosis of patients with MSA-P and PD with lower urinary tract symptoms.

Clinical diagnostic value of combined detection of serum and bronchoalveolar lavage fluid galactomannan for invasive pulmonary aspergillosis in non-neutropenic children / 中华微生物学和免疫学杂志

Objective:To investigate the clinical diagnostic value of combined detection of serum and bronchoalveolar lavage fluid (BALF) galactomannan (GM) for invasive pulmonary aspergillosis (IPA) in children with non-neutropenia.Methods:An analysis was made on 100 children with non-neutropenia suspected of invasive pulmonary aspergillosis in the respiratory ward of the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2019 to March 2020. All of them were tested by serum and BALF GM tests as well as sputum and BALF culture for fungi. The sensitivity, specificity and accuracy of serum and BALF GM in the diagnosis of IPA in non-neutropenic children were analyzed. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the clinical diagnostic value of serum and BALF GM tests for IPA in children with non-neutropenia.Results:The recruited 100 cases included one confirmed case, 85 clinically diagnosed cases and two suspected cases, while the 12 cases were excluded. The accuracy and 95% confidence interval (95%CI) of serum and BALF GM tests used alone and in combination in the clinical diagnosis of IPA in non-neutropenic children were 29.0% (95%CI: 20.1%-37.9%), 75.0% (95%CI: 66.5%-83.5%) and 81.0% (95%CI: 73.3%-88.7%), respectively. The AUC and 95%CI were 0.645 (95%CI: 0.513-0.778), 0.785 (95%CI: 0.644-0.926) and 0.819 (95%CI: 0.681-0.953), respectively.Conclusions:The combined detection of serum and BALF GM was better than a single indicator in the clinical diagnosis of IPA in non-neutropenic children, suggesting the combined detection was of great value in clinical diagnosis.

Effect of urinary albumin/creatinine ratio on type 2 diabetic retinopathy and its cut-off value for early diabetic retinopathy diagnosis / 中华内分泌代谢杂志

Objective:To evaluate the effect of urinary albumin creatinine ratio (UACR) on diabetic retinopathy (DR) in patients with type 2 diabetes. Receiver operating characteristic (ROC) curve was applied to find the cut-off value of UACR for diagnosing DR.Methods:A prospective cohort study of 2 490 patients with type 2 diabetes was conducted with a mean follow-up of 7 years ranging from 3 to 10 years. Dilated fundus examination was performed once a year, and patient history and clinical data were collected and analyzed. Patients were divided into three groups according to the UACR: Q1, normal urinary albumin group (UACR<30 mg/g), Q2, microalbuminuria group (30 mg/g≤UACR≤299 mg/g), and Q3, macroalbuminuria group (UACR>300 mg/g), respectively. Cox regression analysis was used to explore the influence of UACR and other factors on DR, and ROC curve was drawn to evaluate the value of UACR in diagnosis of DR.Results:Cox regression analysis showed that UACR was the risk factor of DR( HR=1.108, 95% CI 1.023-1.241, P<0.001). It showed that the patients in Q3 group had the highest risk of proliferative DR ( HR=3.128, 95% CI 2.025-4.831, P<0.001), the patients in Q2 group followed( HR=1.918, 95% CI 1.355-2.714, P<0.001), and the patients in Q1 group were the lowest. ROC curve analysis showed that area under UACR curve was 0.746(95% CI 0.681-0.812, P<0.001), and the cut-off value, sensitivity, and specificity for the diagnosis of PDR were 54.12mg/g, 0.769, and 0.653, respectively. Conclusion:The UACR can predict the progression of PDR in type 2 diabetes patients, therefore it may be used as a preliminary predictor for the progression of DR.

Three obesity indicators predicting central obesity in Naxi and Pumi ethnic groups in Yunnan Province and inter-ethnic comparison / 解剖学报

Objective To compare the predicted value of three different obesity indicators of on center obesity of Naxi and Pumi adult in Lijiang City, Yunnan Province; To calculate the best cut-off point of waist-to-height ratio(WHtR), body mass index(BMI) and abdominal volume index(AVT); And to compare the differences of BMI and WHtR between the Naxi, Pumi and North-South ethnic groups, so as to provide scientific reference for central obesity and related diseases. Methods By random sampling, 658 cases of Naxi adults (278 cases for men and 380 cases for women) and 496 cases of Pumi adults (2 1 6 cases for men and 280 cases for women) were selected as the subjects of the study, taking the internationally recognized visceral fat level (V F L) as the diagnostic criterion of central obesity, the relationship between WHtR, BMI, AVI and VFL was discussed by regression analysis, and the value of three obesity indicators was predicted by comparing the receiver operating characteristic (ROC) curve of the subjects. Using Excel 2019 to draw diagrams and SPSS 23. 0 to process data. Results The six indicators of age, weight, height, waist circumference, hip circumference and AVI of Naxi and Pumi men were statistically significant among different ethnic groups (P < 0 . 05); Naxi and Pumi women' s age, height, waist circumference, WHtR, BMI and abdominal volume index, the six indicators were statistically significant among different ethnic groups (P < 0 . 0 1) . Correlation analysis showed that the three indicators of WHtR, BMI and AVI were positively related to VFL (P< 0 . 0 1) . The ROC showed that the WHtR had the highest value for predicting central obesity in Naxi and Pumi men (P<0. 01), BMI had the highest value of predicting central obesity in Naxi and Pumi women (P<0. 0 1) . Cluster analysis showed that Naxi and Pumi males were similar to southern ethnic groups such as Lisu and Sui, Naxi females were similar to Zang and Jingpo, and Pumi females were similar to southern ethnic groups such as Lisu and Sui. Conclusion WHtR, BMI, AVI to determine central obesity are statistically significant, can be combined with BMI and AVI to determine Naxi, Pumi central obesity.

The Chinese version of the Chelsea Critical Care Physical Assessment Tool applied in critically ill patients / 中国实用护理杂志

Objective:To explore the threshold and diagnostic value of Chinese version of the Chelsea Physical Function Assessment Tool (CPAx-Chi) for ICU acquired weakness(ICU-AW).Methods:To learn the details and precautions of the CPAx-Chi scale, and then two researchers used the CPAx-Chi scale and MRC-Score scale to independently evaluate 200 patients who come from a comprehensive ICU in a top first-class hospital in Gansu Province simultaneously. The best cut-off point and value of the CPAx-Chi scale in the diagnosis of ICU-AW were determined by calculating the Receiver Operating Characteristic (ROC) curve, the Youden index(YI) and the consistency test that are all based on the MRC-Score≤48.Results:The ROC Area Under Curve(AUC) of the CPAx-Chi scale diagnosis ICU-AW which based on the MRC-Score≤48 were as follows: ROC AUC of group A was 0.899 (95% CI 0.862-1.025); ROC AUC of group B was 0.874 (95% CI 0.824-0.925). When the best cut-off point of CPAx-Chi scale for diagnosis ICU-AW was 31.5, the maximum YI=0.643, the sensitivity was 87%, and the specificity was 77% in group A; and the maximum YI= 0.62, the sensitivity was 75%, and the specificity was 87% in group B. Meanwhile, when the best cut-off point of CPAx-Chi scale for diagnosis ICU-AW was 30.5, the maximum YI=0.62, the sensitivity was 79%, and the specificity was 83% in group B. Taking the CPAx -Chi≤31 as the best cut-off point, the score differences in ICU-AW group and the non-ICU-AW group were not detected, A group ( F value was 4.53, P=0.035) or B group ( F value was 6.51, P=0.011). The consistency of CPAx -Chi≤31 and MRC-Score≤48 in the diagnosis of ICU-AW was high, and the Kappa=0.845 ( P=0.02) in the group A; the Kappa=0.839( P=0.04) in the group B, and the group differences were detected. Conclusions:CPAx-Chi≤31 is the best cut-off point for diagnosing ICU-AW, and has good sensitivity and specificity. CPAx-Chi scale can be popularized and applied in the critical care medicine in China.