Analysis Of Diagnostic Efficiency Research Articles

Expression levels and clinical significance of serum miR-19a/CCL20 in patients with acute cerebral infarction.

Acute cerebral infarction (ACI) is a lethal disease whose early diagnosis is critical for treatment. microRNA (miR)-19a targets CC chemokine ligand 20 (CCL20) in myocardial infarction. We investigated the expression patterns of serum miR-19a and CCL20 of ACI patients and assessed their clinical values. Serum samples of 50 healthy subjects and110 ACI patients were collected. Serum levels of miR-19a, CCL20 mRNA, and biochemical indexes were assessed. miR-19a downstream target gene and the binding relationship between miR-19a and CCL20 were predicted and verified. miR-19a and CCL20 mRNA were subjected to correlation and diagnostic efficiency analysis. miR-19a was poorly expressed in the serum of ACI patients, especially in patients with unstable plaque and large infarction. tumor necrosis factor-α, low-density lipoprotein, and platelet/lymphocyte ratio negatively correlated with serum miR-19a level and positively correlated with CCL20. Dual-luciferase assay revealed that miR-19a could negatively regulate CCL20 expression. CCL20 was highly expressed in the serum of ACI patients. The area under receiver-operating characteristic curve of miR-19a combined with CCL20 was 0.9741 (98.00% specificity, 90.91% sensitivity), higher than their single diagnosis. Collectively, miR-19a had high diagnostic value for ACI and could target to restrain CCL20. The combination of miR-19a and CCL20 improved diagnostic value for ACI.

Surgical evidence-based comparison of [68Ga]Ga-FAPI-04 PET and MRI-DWI for assisting debulking surgery in ovarian cancer patients.

Imaging assessment of abdominopelvic tumor burden is crucial for debulking surgery decision in ovarian cancer patients. This study aims to compare the efficiency of [68Ga]Ga-FAPI-04 FAPI PET and MRI-DWI in the preoperative evaluation and its potential impact to debulking surgery decision. Thirty-six patients with suspected/confirmed ovarian cancer were enrolled and underwent integrated [68Ga]Ga-FAPI-04 PET/MRI. Nineteen patients (15 stage III-IV and 4 I-II stage) who underwent debulking surgery were involved in the diagnostic efficiency analysis. The images of [68Ga]Ga-FAPI-04 PET and MRI-DWI were visually analyzed respectively. Immunohistochemistry on FAP was performed in metastatic lesions to investigate the radiological missing of [68Ga]Ga-FAPI-04 PET as well as its different performance in primary debulking surgery (PDS) and interval debulking surgery (IDS) patients. Potential imaging impact on management was also studied in 35 confirmed ovarian cancer patients. [68Ga]Ga-FAPI-04 PET displayed higher sensitivity (76.8% vs.59.9%), higher accuracy (84.9% vs. 80.7%), and lower missing rate (23.2% vs. 40.1%) than MRI-DWI in detecting abdominopelvic metastasis. The diagnostic superiority of [68Ga]Ga-FAPI-04 PET is more obvious in PDS patients but diminished in IDS patients. [68Ga]Ga-FAPI-04 PET outperformed MRI-DWI in 70.8% abdominopelvic regions (17/24), which contained seven key regions that impact the resectability and surgical complexity. MRI-DWI hold advantage in the peritoneal surface of the bladder and the central tendon of the diaphragm. Of the contradictory judgments between the two modalities (14.9%), [68Ga]Ga-FAPI-04 PET correctly identified more lesions, particularly in PDS patients (73.8%). In addition, FAP expression was independent of lesion size and decreased in IDS patients. [68Ga]Ga-FAPI-04 PET changed 42% of surgical planning that was previously based on MRI-DWI. [68Ga]Ga-FAPI-04 PET is more efficient in assisting debulking surgery in ovarian cancer patients than MRI-DWI. Integrated [68Ga]Ga-FAPI-04 PET/MR imaging is a potential method for planning debulking surgery in ovarian cancer patients.

ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА РЕЧЕВЫХ НАРУШЕНИЙ У ДЕТЕЙ С АУТИЗМОМ И СПЕЦИФИЧЕСКИМИ РАССТРОЙСТВАМИ РЕЧИ И ЯЗЫКА

A wide range of speech disorders causes the complex structure of the defect, which results in a disharmonious clinical and psychological characteristic of autism. The expediency of using the method of speech disorders in children with infantile autism is justified by the results of diagnostic efficiency analysis from the standpoint of evidence-based medicine. A wide range of speech disorders causes the complex structure of the defect, which results in a disharmonious clinical and psychological characteristic of autism. Objectivization of speech pathologies with the help of scientifically grounded diagnostic method of speech disorders in children with infantile autism gives an opportunity to create a speech profile of the child, which helps to determine the principles of their correction. The expediency of using the method is justified by the results of diagnostic efficiency analysis from the standpoint of evidence-based medicine.

Contrast-enhanced Ultrasound Combined With Elastography for the Evaluation of Muscle-invasive Bladder Cancer in Rats.

By comparing with the control group, we evaluated the usefulness of contrast-enhanced ultrasound (CEUS) combined with elastography for the assessment of muscle invasion by bladder cancer (MIBC) in a Sprague-Dawley (SD) rat model. In the experimental group, 40 SD rats developed in situ bladder cancer (BLCA) in response to N-methyl-N-nitrosourea treatment, whereas 40 SD rats were included in the control group for comparison. We compared PI, Emean , microvessel density (MVD), and collagen fiber content (CFC) between the two groups. In the experimental group, Bland-Altman test was used to assess the relationships between various parameters. The largest Youden value was used as the cut-off point, and binomial logistic regression analysis was performed to analyze the PI and Emean . Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic power of parameters, individually and in combination. The PI, Emean , MVD, and CFC were significantly lower in the control group than in the experimental group (P < .05). The PI, Emean , MVD, and CFC were significantly higher for MIBC than for non-muscle-invasive bladder cancer (P < .05). There were significant correlations between PI and MVD, and between Emean and CFC. The diagnostic efficiency analysis showed PI had the highest sensitivity, CFC had the highest specificity, and PI + Emean had the highest diagnostic efficacy. CEUS and elastography can distinguish lesions from normal tissue. PI, MVD, Emean , and CFC were useful for the detection of BLCA myometrial invasion. The comprehensive utilization of PI and Emean improved diagnostic accuracy and have clinical application.

Combined analysis of C-reactive protein in pleural fluid and serum is effective in the differential diagnosis of exudative pleural effusions.

BackgroundExudative pleural effusion (EPE) is one of the common pleural manifestations of various diseases. Differential diagnosis of EPE is imperative clinically as it identifies different causes of EPE, thereby, enabling effective treatments. Thoracoscopy is a useful tool for differential diagnosis of EPE; however, some patients refuse thoracoscopic examination due to its invasive nature. In addition, the specificity and sensitivity of existing routine tests of EPE are unsatisfactory. Therefore, there is a great need to establish an effective method for the differential diagnosis of EPE.MethodsThis study was a single-institution retrospective analysis of diagnostic efficiency of C-reactive protein (CRP) and procalcitonin (PCT) between March 2018 and September 2018. A total of 87 patients diagnosed with EPE were enrolled. All participants underwent diagnostic thoracentesis. The EPE was examined using biochemical, routine, microbiological, and cytological methods. Pathological cytology detection was necessary for those suspected of malignant PE. Benign PE originates in patients with pneumonia, empyema, and tuberculosis. The levels of CRP and PCT in EPE and serum were measured before treatment. Correlation analysis and receiver-operating characteristic (ROC) curve analysis were conducted to determine the underlying relationship between levels of CRP and PCT, and for differential diagnosis.ResultsThe ROC analysis showed that the sensitivity and specificity for the analysis of pleural fluid CRP (p-CRP) were higher (cut-off: 17.55 pg/mL; sensitivity: 75.00%, specificity: 83.90%) than that of serum CRP (s-CRP, cut-off: 23.90 pg/mL; sensitivity: 71.00%, specificity: 80.4%) in the differential diagnosis for EPE. However, the analysis of pleural fluid PCT (p-PCT) and serum PCT (s-PCT) did not demonstrate correlations with EPE. Combined analysis of p-CRP (cut-off: 17.55 mg/dL) with s-CRP (cut-off: 23.9 pg/mL) showed the highest diagnostic accuracy (88.4%) in diagnosing infectious EPE.ConclusionsThe data support the close relationship between combined analysis of p-CRP with s-CRP and effective and accurate differential diagnosis of EPE, due to its higher sensitivity and specificity. However, as a highly sensitive marker for diagnosing bacterial infections, neither s-PCT nor p-PCT, showed correlations with the differential diagnosis of EPE.

Application of ultrasound in the diagnosis and preoperative evaluation of cystic hepatic echinococcosis

Objective: To investigate the value of ultrasound in the diagnosis and preoperative evaluation of cystic hepatic echinococcosis. Methods: The data of 59 patients (102 lesions) with cystic hepatic echinococcosis confirmed by surgical pathology and serological examination in the Fifth Medical Center of PLA General Hospital from January 2018 to December 2019 were retrospectively analyzed, including 23 males and 36 females; age13 to 64 (42±6) years. The ultrasonographic manifestations were classified, and the involvement of the lesions in the blood vessels and bile ducts was determined. The coincidence rate between ultrasound diagnosis of hepatic echinococcosis and surgical pathology was compared, and the accuracy, sensitivity and specificity of ultrasounic diagnosis of hepatic echinococcosis were analyzed. Results: Ultrasound showed 12 CE1 type lesions, 24 CE2 type lesions, 16 CE3a type lesions, 6 CE3b type lesions, 34 CE4 type lesions, and 10 CE5 type lesions. The coincidence rates of hydatid ultrasound and surgical pathological classification were 91.66% (11/12), 95.80% (23/24), 93.75% (15/16), 83.33% (5/6), 91.17% (31/34) and 100.00% (10/10), respectively. Ultrasound diagnostic efficiency analysis: the accuracy of classification was 94.12%, the sensitivity was 96.94%, and the specificity was 25%. Among the characteristic ultrasound manifestations, the gyrus sign and the polycystic sign were the most frequent, followed by homogeneous thickening of the cyst wall, double wall, separation of the inner cyst wall, and thick wall calcification. There were significant differences between ultrasound in the determination of lesions involving blood vessels and bile ducts and intraoperative findings (all P<0.05). Conclusion: Ultrasound could clearly diagnose cystic hepatic echinococcosis, could better display the imaging characteristics of the disease, and had important clinical significances in indicating the evolution of the disease and determining the involvement of the lesions in the blood vessels and bile ducts.

Preliminary analysis of diagnostic efficiency of vascular morphology distribution in breast tumor by superb microvascular imaging

Objective To compare the differences of superb microvascular imaging (SMI) and color Doppler flow imaging (CDFI) in the diagnosis of breast tumor microvessels and explore the value of microvascular morphological features in the detection of benign and malignant tumors. Methods SMI and CDFI were performed in 105 patients (105 breast tumors) in the breast surgery in our hospital. The morphological characteristics of the microvessels of the breast tumor were observed. Their values in the diagnosis of the benign and malignant of the tumor were compared with the pathological results. Results There were statistically differences in differentiation of microvascular morphologic types of benign and malignant breast tumors between SMI and CDFI (P=0.021, 0.042). The type of diagnosing benign tumors was no blood vessel, linear and treelike. The type of diagnosing malignant tumors was root hair-like and crab claw-like. The susceptibility, specificity and accuracy of SMI and CDFI in diagnosing breast tumors were 85.36%, 93.75%, 90.47% and 63.41%, 90.47%, 81.90%. The area of the two ROC curves were 0.896 and 0.786. The results of the Z test show that the diagnostic efficacies of the two methods were statistically significant(Z=2.265, P=0.037). Conclusions SMI is more effective than CDFI in detecting low velocity microvessels in breast tumors. Its morphological typing is of clinical significance in the diagnosis of benign and malignant tumors. Key words: Superb microvascular imaging; Color Doppler flow imaging; Breast neoplasms; Microvessels

Computed tomography pulmonary angiography versus ventilation-perfusion lung scanning for diagnosing pulmonary embolism during pregnancy: a systematic review and meta-analysis.

Differences between computed tomography pulmonary angiography and ventilation-perfusion lung scanning in pregnant patients with suspected acute pulmonary embolism are not well-known, leading to ongoing debate on which test to choose. We searched in PubMed, EMBASE, Web of Science and the Cochrane Library databases and identified all relevant articles and abstracts published up to October 1, 2017. We assessed diagnostic efficiency, frequency of non-diagnostic results and maternal and fetal exposure to radiation exposure. We included 13 studies for the diagnostic efficiency analysis, 30 for the analysis of non-diagnostic results and 22 for the radiation exposure analysis. The pooled rate of false negative test results was 0% for both imaging strategies with overlapping confidence intervals. The pooled rates of non-diagnostic results with computed tomography pulmonary angiography and ventilation-perfusion lung scans were 12% (95% confidence interval: 8-17) and 14% (95% confidence interval: 10-18), respectively. Reported maternal and fetal radiation exposure doses were well below the safety threshold, but could not be compared between the two diagnostic methods given the lack of high quality data. Both imaging tests seem equally safe to rule out pulmonary embolism in pregnancy. We found no significant differences in efficiency and radiation exposures between computed tomography pulmonary angiography and ventilation-perfusion lung scanning although direct comparisons were not possible.

Estimated fetal weight percentile as a tool to predict collection of cord blood units with higher cellular content: implications for prenatal selection of cord blood donors.

The need for high-cellular-content cord blood units (CBUs) for allogenic transplantation is evident to improve clinical outcomes. In our environment and with current donation programs, very few collected units meet suggested clinical thresholds, making collection programs highly inefficient. To increase the clinical conversion rate, we have assessed factors influencing the cellular content of the cord blood collection and established the estimated fetal weight percentile (EFWp) as a tool to predict which deliveries will obtain higher cellular counts. We conducted a retrospective analysis of 11,349 collected CBUs. An analysis of diagnostic efficiency (receiver operating characteristic [ROC] curve) was performed to establish the cutoffs of several obstetric and perinatal variables from which we would obtain more than 1500 × 106 total nucleated cells and 4 × 106 CD34 cells. We then calculated the optimal EFWp cutoff to increase efficiency. In the univariate analysis, factors positively and significantly associated were a greater neonatal and placental weight and longer weeks of gestation. In the multivariate analysis only neonatal and placental weight remain significant (p < 0.001). The ROC curve analysis showed that the optimal EFWp cutoff is 60, which has the maximum area under the curve. Applying this, donations meeting clinical cellular numbers will increase more than 30% with respect to not using any threshold. The EFWp predicts the quality of the collected CBUs and can be used to make a prenatal selection of the donors, therefore increasing the efficiency of umbilical cord blood collection programs.

Estudio de correlación entre la concentración de antígeno de superficie y la carga viral del virus de la hepatitis B en una población negativa para el antígeno e

BackgroundPossible lack of correlation observed among serum hepatitis B surface antigen (HbsAg) concentration results and viral load in our hospital, and the great controversy surrounding this aspect in the literature, has motivated this study. Additionally, diagnostic efficiency analysis of quantitative HbsAg measurement are done in order to verify the real usefulness of the introduction of this test in our laboratory. Methods150 hepatitis B chronic carriers samples have been used. Negative HbeAg individuals were divided in four groups (HbsAg < 1,000 UI/mL [subgroup 1], HbsAg > 1,000 UI/mL [subgroup 2], DNA < 2,000 UI/mL [subgroup 3], DNA > 2,000 UI/mL [subgroup 4]). Both quantitative HbsAg and qualitative HbeAg have been performed by a chemiluminiscent immunoassay from Architect® i2000SR analyzer (Abbott Laboratories, Sligo, Ireland). Viral load has been quantified by real time polymerase chain reaction (RT-PCR) (Cobas Ampliprep/Cobas TaqMan® from Roche Diagnostics) (Manheim, Germany). Correlation studies have been performed by the Spearman test. Statistical analysis have been performed using MedCalc® software. ResultsCorrelation coeficients obtained in this study have been: Total negative HbeAg group (r=0.322; p=.0002); subgroup 1 (r=0.501; p=.0001); subgroup 2 (r=-0.105; p=.362); subgroup 3 (r=0.275; p=.0052); subgroup 4 (r=0.299; p=.092). ConclusionModest but significant correlation between HbsAg levels and VHB-DNA values in negative HbeAg individuals has been observed.

Analysis of diagnostic efficiency of lung ventilation parameters in patients with bronchial asthma

The goal of this work was to perform probabilistic assessment of the diagnostic efficiency of lung ventilation parameters in patients with bronchial asthma. The efficiency of the suggested method was compared with that of the widely used technique of contrast of means. Study was performed in 365 patients with bronchial asthma and 216 apparently healthy subjects. Structural analysis of the diagnostic efficiency of lung ventilation parameters was performed on the basis of pooled and separate estimates. The results of the study made it possible to classify the lung ventilation parameters according to the degree of their diagnostic validity.

Structural Analysis of Diagnostic Efficiency of Bodyplethysmography in Patients with Bronchial Asthma

In the paper the probabilistic assessment of diagnostic efficiency of bodyplethysmography indexes in patients with bronchial asthma instead of the prevailing method of comparison of mean-value is carried out. It is shown, that the estimation of diagnostic efficiency of body-plethysmography indexes by probabilistic methods in patients with bronchial asthma has advantages in comparison with a traditional estimation of mean-value as allows to determine the information density of each size from a position of probability and to improve functional diagnostics of this disease.

Neuropsychological functioning among the nonpsychotic relatives of schizophrenic patients: A diagnostic efficiency analysis.

Numerous studies suggest that the relatives of schizophrenic patients exhibit neuropsychological impairments that are milder yet similar to those seen among schizophrenic patients. The authors assessed 35 nonpsychotic relatives of schizophrenic patients and 72 normal controls using a clinical and experimental neuropsychological test battery. Three neuropsychological functions met criteria for risk indicators of the schizophrenia genotype: abstraction, verbal memory, and auditory attention. These findings could not be attributed to parental socioeconomic status, education, general visual-spatial ability, or psychopathology. Furthermore, exploratory analyses were performed to determine whether the diagnostic efficiency of the indicators could be adjusted to meet the needs of genetic linkage analyses. These analyses suggest that psychometric considerations may help to create measures for genetic linkage studies.