Objective To investigate the value of adenosine deaminase (ADA) for the diagnosis of tuberculous serous cavity fluidify. Methods The literatures on the application of ADA for the diagnosis of tuberculous serous cavity fluidify in the database including PUBMED and CNKI were reviewed. Results Studies including randomized controlled trial or meta-analysis have performed to determine the level of ADA in the effusion of tuberculous serous cavity fluidify. These studies have sufficiently proved that ADA is a specific and sensitive method for the diagnosis of extrapulmonary tuberculosis. Most of the studies have determined the optimal cut-off value of ADA in the effusion of tuberculous serous cavity fluidify. Conclusion Measurement of ADA in the effusion of tuberculous serous cavity fluidify is widely used as a fast, convenient, safe and effective adjunctive diagnostic method of tubeculosis in clinic.
Objective To evaluate the diagnostic value of human heart-type fatty acid-binding protein for early detection of acute myocardial infarction (AMI). Methods Studies involving this biomarker were identified from MEDLINE, EMbase, CBM and VIP (1970 to 2006). Relevant journals (1980 to 2006) were also handsearched. The quality of the included studies was assessed using the QUADAS tool. Data extraction and analysis were conducted by software of EXCEL2003 and Metadisc. Results We included 13 studies, which were heterogeneous (P=0, I2=58.5%). Five studies (n=396) included in the group assessed the test at the first three hours after chest pain onset. These studies were homogeneous (P= 0.49, I2=0). The pooled sensitivity was 0.86 ( 95%CI 0.80 to 0.91), the pooled specificity was 0.76( 95%CI 0.80 to 0.91), and the area under the curve was 0.88 (SE=0.032 3). In the group of 0 to 6 hours after chest pain onset, 10 included studies (n=1 175) were heterogeneous (P=0, I2=69%). The pooled sensitivity was 0.86 (95%CI 0.83 to 0.89), the pooled specificity was 0.79 (95%CI 0.76 to 0.82), and the area under the curve was 0.92 (SE=0.019). In the group of 6 to 12 hours after chest pain onset, 4 included studies (n=215) were homogeneous (P=0.56, I2=0). The pooled sensitivity was 0.97 (95%CI 0.91 to 0.99), the pooled specificity was 0.52 (95%CI 0.42 to 0.61), and the area under the curve was 0.810 with (SE=0.152 2). In the group of 0 to 12 hours after chest pain, 11 included studies (n=1 352) were heterogeneous (P=0.56, I2=59%). The pooled sensitivity was 0.88 (95%CI 0.84 to 0.89), the pooled specificity was 0.75 (95%CI 0.71 to 0.78), and the areas under the curve was 0.91 (SE=0.016 4). Conclusions In this systematic review, we found that H-FABP has an acceptable diagnostic accuracy within 3 hours after the onset of symptoms, and within 12 hours after the onset of symptoms, H-FABP has a high diagnostic efficacy. So H-FABP may be a new symbol for the early diagnosis of AMI.
Objective To evaluate the diagnostic value of anti-nucleosome antibody (AnuA) in patients with systemic lupus erythematosus (SLE). Methods We searched MEDLINE, EMbase and The Cochrane Library to identify studies on the diagnostic value of AnuA in patients with SLE. The searching time was from 1990 to 2005. The quality of included studies was evaluated and the data were extracted. The Cochrane Collaboration’s RevMan software was used to analyze heterogeneity, and MetaDisc was used to perform meta-analyses and draw summary receiver operator characteristic curve (SROC). Results Twenty-five studies involving 7 289 patients (2 459 SLE and 5 030 non-SLE patients were diagnosed by gold standard) were included, most of which were poor in quality. The heterogeneity among studies was high (Plt;0.000 01, I2=87.2%). The pooled sensitivity was 64.9%, 95% CI 63.0 to 66.85, and the pooled specificity was 92.6%, 95% CI 91.8% to 93.3%. Area under the SROC was 0.918, SE0.0212. These data suggested that AnuA had a relatively high false negative rate (35.1%) and a relatively low false positive rate (7.4%). Conclusions AnuA has some value in diagnosing SLE and could possibly be used as one of the diagnostic tests for SLE.
【摘要】 目的 探讨B型超声对肺不张的诊断价值。 方法 对2007年5月-2009年5月收治的67例肺不张患者的CT诊断与B型超声诊断进行对照、分析、总结。 结果 B型超声诊断一侧肺不张和肺叶肺不张与CT诊断符合率为94.64%，肺段型肺不张诊断符合率为54.55%。 结论 B型超声诊断可作为肺不张筛查的首选诊断方法。【Abstract】 ObjectiveT o study the diagnostic value of atelectasis by type-B ultrasonography. Methods Data of 67 cases of patients with atelectasis diagnosed by type-B ultrasonography and CT were compared, analyzed, and summarized between May 2007 and May 2009. Results The diagnosis coincidence rate which was got by comparing ultrasonography diagnosis of the one side atelectasis and pulmonary lobectomy atelectasis with CT diagnosis was 94.64%, and that of pulmonary segmental atelectasis was 54.55%. Conclusion Type-B ultrasonography can be used as the preferred screening atelectasis diagnosis.
ObjectiveTo evaluate the diagnostic value of T-SPOT.TB assay in patients with hematological disorders and tuberculosis. MethodsA total of 82 patients with hematological disorders and suspected tuberculosis diagnosed between March 2012 and April 2013 received T-SPOT. TB assay in the peripheral blood mononuclear cells. ResultsThe positive detection rate of T-SPOT.TB assay for patients with hematological disorders and tuberculosis was 59.09% (13/22), which was higher than the positive detection rate of anti-TB antibody test[13.64% (3/22)]. The sensibility and specificity of T-SPOT.TB assay for patients with hematological disorders and tuberculosis was 59.09% (13/22) and 68.33% (41/60), respectively. ConclusionT-SPOT.TB assay is of great value on diagnosis of tuberculosis for patients with hematological disorders and suspected tuberculosis. The diagnostic value of T-SPOT.TB assay is more important for tuberculosis infected patients; it can be used as an accessorial diagnostic method for patients with hematological disorder and suspected tuberculosis.
ObjectiveTo investigate the morphology of brain regions undergoing multiple sclerosis (MS) MRI, and furthermore, to investigate possible diagnostic values of MRI for MS. MethodsMRI images of 42 MS patients (34 females and 8 males, aged between 35 and 81 years old, averaging at 58) who visited the hospital during the time from December 2007 to December 2013 were collected and analyzed. Routine T1, T2 and fluid attenuated inversion recovery (FLAIR) scans were performed on all the 42 patients. Sagittal T1, T2 and FLAIR scans were performed when necessary. Contrast-enhanced MRI was performed on 9 of the 42 patients. The abnormal findings from MRI scans of all the 42 patients were analyzed. The analysis was further concluded to yield general characteristics of MS patients under MRI. ResultsA total of 286 lesions were identified in 42 patients. Ninety (31.6%) of the 286 lesions (seen in 35 patients) were found to locate around lateral ventricles; 67 (23.4%) at centrum semiovale (seen in 29 patients); 59 (20.6%) in deep white matter (seen in 28 patients); 46 (16.1%) around corpus callosum (seen in 30 patients); 21 (7.3%) in brain stem, basal ganglia and cerebellar hemispheres (seen in 9 patients); and 3 (1.0%) at cervical spinal cord. In routine MRI images, the lesions showed up as low T1 signal, high T2 signal and high FLAIR signal with the shape of ovoid or round. No mass effect was observed in lesions. In the contrast-enhanced MRI images, the 25 observed lesions showed mild enhancements with the shape of ring, semi-ring and arc. ConclusionCertain characteristic features can be observed in MS MRI images. MRI is an effective diagnostic method for multiple sclerosis diagnosis.
ObjectiveTo study the diagnostic significance of modified Alvarado Score System for different types of acute appendicitis. MethodsClinical data of 1 930 cases of acute appendicitis, who underwent appendicectomy in The First Hospital of Yulin from Jan. 2004 to Jan. 2014, were retrospectively collected. Then the diagnostic significance of Modified Alvarado Score System was detected and evaluated by receiver operating characteristic (ROC) curve, and its correlation with postoperative pathological results was calculated. ResultsThe modified Alvarado score of cases in progressive group was higher than that of simplex group (7.5±1.3 vs. 3.6±0.7, P < 0.001). The areas under ROC curve of modified Alvarado Score System was 0.943 (95% CI:0.929-0.958, P < 0.001). The critically diagnostic points of Modified Alvarado Score System for differential diagnosis of simplex acute appendicitis and progressive acute appendicitis was 6 score, with sensitivity of 92.9%, specificity of 86.3%, positive predictive value of 96.9%, negative predictive value of 72.6%, positive likelihood ratio of 6.8, negative likelihood ratio of 0.1, and Youden index of 91.7%. ConclusionThis Modified Alvarado Score System has a certain significance for the type diagnosis of acute appendicitis.
ObjectiveTo evaluate the value of 120 kV portal venous phase images combined with iodine maps created from dual-source dual-energy CT (DECT) for the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. MethodsThis prospective study enrolled 17 patients who underwent abdominal dual-source DECT within 72 hours from the onset of acute pancreatitis. All patients had received treatment in West China Hospital from May 2014 to August 2014. Comparison of the diagnostic value of 120 kV portal venous phase images alone and 120 kV portal venous phase images combined with iodine maps created from dual-source DECT was performed. ResultsSix of the 17 patients were found the presence of pancreatic necrosis (4 patients without obvious necrosis in the early stage developed to pancreatic necrosis, and 2 patients with the presence of necrosis in the early stage improved). The sensitivity, specificity, and accuracy of 120 kV portal venous phase images for the diagnosis of pancreatic necrosis were 50.0% (3/6), 100% (11/11), and 82.4% (14/17), respectively, and it had a good diagnostic value (AUC=0.856, P=0.018). The sensitivity, specificity, and accuracy of 120 kV portal venous phase images combined with iodine maps created from dual-source DECT for predicting pancreatic necrosis were 100% (6/6), 90.9% (10/11), and 94.1% (16/17), respectively, and this method had good value too (AUC=0.977, P=0.002), which higher than that of 120 kV portal venous phase images (P=0.002). ConclusionsThe 120 kV portal venous phase images combined with iodine maps created from dual-source DECT is helpful to improve subjective judgment in the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. It also contributes to the display of hypo-perfusion area of the pancreatic parenchyma, and has higher diagnostic value.