Diagnostic Coincidence Research Articles

Diagnostic value of echocardiography in fetal cardiac malformation and clinical classification.

Diagnostic value of echocardiography in fetal cardiac malformation and clinical classification was investigated. In total, 206 high-risk parturients, who received a screening of prenatal fetal cardiac malformation in Jinan Maternity and Child Care Hospital from January 2015 to June 2017, were retrospectively analyzed, among those parturients, the results of labor induction or newborns of 141 parturients were diagnosed as cardiac malformation, the fetuses of 65 parturients were diagnosed as non-cardiac malformation, the detection of fetal cardiac malformation of all the parturients was carried out by two-dimensional ultrasound and four-dimensional ultrasound during gestation period, presence or absence of congenital cardiac malformation of the fetuses and clinical classification were estimated. The sensitivity of two-dimensional ultrasound diagnosis combined with four-dimensional ultrasound diagnosis was significantly higher than that of two-dimensional ultrasound diagnosis and four-dimensional ultrasound diagnosis (P<0.05). In addition, the sensitivity of four-dimensional ultrasound diagnosis was significantly higher than that of two-dimensional ultrasound diagnosis (P<0.05). The specificity and positive predictive value of four-dimensional ultrasound diagnosis were significantly higher than those of two-dimensional ultrasound diagnosis and two-dimensional ultrasound diagnosis combined with four-dimensional ultrasound diagnosis (P<0.05). The diagnostic coincidence rates of four-dimensional ultrasound diagnosis and two-dimensional ultrasound diagnosis combined with four-dimensional ultrasound diagnosis were significantly higher than that of two-dimensional ultrasound diagnosis (P<0.05). The negative predictive values of the combined ultrasound diagnosis and four-dimensional ultrasound diagnosis were significantly higher than that of two-dimensional ultrasound diagnosis (P<0.05). The diagnostic efficiency of two-dimensional ultrasound combined with four-dimensional ultrasound was good in the diagnosis of fetal cardiac malformation in prenatal period of pregnant women, it could improve detection rate of fetal cardiac malformation and is worthy of being generalized in clinic.

Diagnostic value and clinical significance of ultrasound combined with CT in cystic renal cell carcinoma.

This study investigated the value and clinical significance of ultrasound combined with CT in the diagnosis of cystic renal cell carcinoma. A total of 85 patients with cystic renal cell carcinoma, who were admitted to the Oncology Department of Yantai Yuhuangding Hospital Affiliated to Qingdao University from December 2015 to April 2017, were selected as the study group, and 70 patients with benign renal cyst, who were examined in Yantai Yuhuangding Hospital Affiliated to Qingdao University, were selected as the benign group. The patients in the two groups were examined by ultrasound and CT. The diagnostic value of ultrasound, CT, and ultrasound combined with CT in cystic renal cell carcinoma was analyzed. The sensitivity of ultrasound combined with CT was significantly higher than that of CT and ultrasound (P<0.05). The specificity and diagnostic coincidence rate of ultrasound combined with CT were significantly higher than those of CT (P<0.05). For unicapsular kidney cancer, there was no significant difference among ultrasound, CT and ultrasound combined with CT in the diagnosis of septum and wall nodule (P>0.05). For polycystic kidney cancer, there was no significant difference among ultrasound, CT and ultrasound combined with CT in the diagnosis of the presence or absence of septum (P>0.05). Ultrasound was significantly better than CT in cyst wall confounding (P<0.05). Ultrasound combined with CT was significantly better than ultrasound in calcification and blood supply of tumors (P<0.05). In conclusion, the accuracy of ultrasound combined with CT is higher than that of ultrasound or that of CT in the diagnosis of cystic renal cell carcinoma, which can be beneficial in accurately carrying out clinical diagnosis, reduce the incidence of missed diagnosis and misdiagnosis caused by a single diagnosis and treatment. Ultrasound combined with CT is good for clinical screening and can guide clinical symptomatic treatment, which is worthy of generalizing in clinic.

Application value of MRI diffuse weighted imaging combined with PET/CT in the diagnosis of stomach cancer at different stages.

Value of MRI diffusion-weighted imaging (MRI DWI) combined with PET/CT in the diagnosis and staging of stomach cancer (SC) was investigated. A retrospective analysis was performed on 160 patients with SC diagnosed by pathological biopsy in The Affiliated Yantai Yuhuangding Hospital of Qingdao University from March 2015 to April 2018. The values of MRI DWI, PET/CT and combined diagnosis in the diagnosis and staging of SC were compared according to the criteria of diagnosis of postoperative pathological or clinical comprehensive evaluation. The sensitivity, specificity and diagnostic coincidence rate of MRI DWI in the diagnosis of SC at stage I–II were 61.05, 64.62 and 62.50%, respectively, which were significantly lower than those of PET/CT (P<0.05). Sensitivity, specificity and diagnostic coincidence rate of MRI DWI in the diagnosis of SC at stage III–IV were lower than those of PET/CT (P<0.05). Sensitivity and diagnostic coincidence rate of MRI DWI combined with PET/CT in the diagnosis of SC at stage I–II were significantly higher than those of MRI DWI or PET/CT alone (P<0.05). Specificity and diagnostic coincidence rate of MRI DWI combined with PET/CT in the diagnosis of SC at stage III–IV were significantly higher than those of MRI DWI or PET/CT alone (P<0.05). PET/CT is superior to MRI DWI in SC staging, whereas the diagnostic efficiency of combined scan is much higher than that of PET/CT or MRI DWI alone. In order to obtain more accurate preoperative staging and to avoid diagnostic exploratory laparotomy, the combination of MRI DWI and PET/CT techniques should be used in the comprehensive analysis of the disease to improve the accuracy of clinical diagnosis.

Comparison of diagnostic values between CA125 combined with CA199 and ultrasound combined with CT in ovarian cancer.

Application values of CA125 combined with CA199 and ultrasound combined with computed tomography (CT) in the clinical diagnosis of ovarian cancer were compared. A retrospective analysis was performed on 168 ovarian cancer patients admitted to the Department of Gynecology in Jining No.1 People's Hospital from July 2013 to March 2016. Of the patients 107 with malignant tumors were in the malignant group, and 61 patients with benign tumors were in the benign group. Another 98 healthy controls in the same period were in the normal group. Chemiluminescence was used for the detection of levels of tumor markers CA125 and CA199 in the serum of all patients. CA125 combined with CA199 and color Doppler ultrasound combined with CT scan were used to diagnose and analyze the sensitivity, specificity, accuracy, and positive detection rate of ovarian cancer patients at different stages. The sensitivity, specificity and diagnostic coincidence rate of ultrasound combined with CT in the diagnosis of ovarian cancer were 97.20, 80.32 and 91.07%, respectively, which were significantly higher than the 92.52, 73.77 and 85.71% of serum CA125 combined with CA199. The positive detection rate of ultrasound combined with CT in the early diagnosis of ovarian cancer was 93.55%, higher than 83.87% of CA125 combined with CA199. The sensitivity, specificity, coincidence rate and positive detection rate of ultrasound combined with CT in the diagnosis were higher than those of CA125 combined with CA199. In the actual diagnosis process, these two diagnostic schemes can be selectively and comprehensively applied, so as to make a correct diagnosis, which is of great significance for reducing patient mortality.

Comparison of diagnostic value of multi-slice spiral CT and MRI for different pathological stages of prostate cancer.

Diagnostic value of magnetic resonance imaging (MRI) and multi-slice spiral CT (MSCT) for different pathological stages of prostate cancer was compared. A total of 112 patients with prostate cancer who underwent surgical pathology in The Affiliated Yantai Yuhuangding Hospital of Qingdao University from February 2014 to January 2016 were enrolled as prostate cancer group, and another 100 patients who received physical health examinations during the same period as the normal group. MSCT and MRI scanning were performed on patients in both groups to analyze their diagnostic value for stages A/B and C/D of prostate cancer. Based on the apparent diffusion coefficient (ADC) value generated by the diffusion-weighted imaging (DWI) in MRI, there was a significant difference in the ADC value between different stages of prostate cancer (P<0.05); the pathological stage was negatively correlated with the ADC value (r=−0.7629, P<0.05), and the higher the stage was, the lower the ADC value was. The sensitivity was significantly higher in the MRI group than that in the MSCT group (92.0 vs. 79.5%, P<0.05), and the specificity was significantly higher in the MRI group than that in the MSCT group (90.0 vs. 70.0%, P<0.05). In the diagnosis of stage A and B of prostate cancer, the diagnostic coincidence rate was 86.7% in the MRI group, and 57.8% in the MSCT group (P<0.05); the misdiagnosis rate and missed diagnosis rate were significantly lower in the MRI group than those in the MSCT group (P<0.05). The accuracy of MRI is higher than that of MSCT in the diagnosis of early prostate cancer. Both MRI and MSCT can accurately detect stages C and D of prostate cancer, but the ADC value in MRI has great clinical significance for judging the risk of the tumor. Therefore, MRI is more valuable than MSCT in the diagnosis of patients with different pathological stages of prostate cancer.

Diagnostic efficacy of PET/CT in bone tumors.

Clinical value of PET/CT (positron emission tomography/computed tomography) in the diagnosis of malignant bone tumors (BT) was investigated. Fifty-four patients with BT were first diagnosed by ordinary CT and then by PET/CT. The diagnostic efficacy outcomes and diagnosis of malignant BT by clinical stage of the two methods for BT were observed and recorded, and the diagnostic value of PET/CT in the diagnosis of BT was evaluated. There were 14 cases of benign BT patients, 15 cases of stage I, 10 cases of stage II and 15 cases of stage III in malignant BT patients. The diagnostic coincidence rate of PET/CT was 92.59% and the diagnostic coincidence rate of CT was 72.22%, which showed that the diagnostic coincidence rate of PET/CT was significantly higher than that of CT (P<0.05). The sensitivity, negative predictive value and positive predictive value of PET/CT were 95.00, 85.71 and 95.00%, respectively, which were higher than those of CT (P<0.05). CT and PET/CT were used for the clinical staging and pathological diagnosis of malignant BT; the results showed that the diagnostic accuracy of PET/CT in the clinical stages of malignant BT was also significantly higher than that of CT (P<0.05). The diagnostic efficacy of PET/CT in BT is better than that in CT. PET/CT can diagnose the pathological properties of BT more accurately, and can also effectively diagnose the clinical stage of malignant BT and provide clinical diagnostic basis for follow-up procedures.

The value of lean nystagmus and sitting to supine positioning nystagmus in the diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo

Objective: To explore the value of 1ean nystagmus and sitting to supine positioning nystagmus in the diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo. Method: One hundred cases of patients with definitive diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo were tested by 1ean nystagmus and sitting to supine positioning nystagmus and supine roll test. The affected side was recorded according to the nystagmus direction. After diagnosis, they were treated with canalith repositioning procedure. The canalith repositioning procedure was made according to the supine roll test result when 1ean nystagmus and sitting to supine positioning nystagmuscannot be induced. Furthermore，the canalith repositioning procedure was made according to the1ean nystagmus and sitting to supine positioning nystagmuswhenthe supine roll test cannot diagnose. The patients with canalolithiasis were randomly divided into two groups when both 1ean nystagmus and sitting to supine positioning nystagmusand the supine roll test can be induced. One group was treated with canalith repositioning procedure based on results of supine roll test and the other group was treated based on the results of1ean nystagmus and sitting to supine positioning nystagmus. The detection rate and diagnostic coincidence rate of 1ean nystagmus and sitting to supine positioning nystagmus were calculated and the shortterm outcome were evaluated one day after treatment. Result: The detection rate of 1ean nystagmus and sitting to supine positioning nystagmus was 83% and the coincidence rate with the roll test was 90.1%，respectively. There was no significant statistical difference between the treatment effect according to lean nystagmus and sitting to supine positioning nystagmus and supine roll test. Conclusion: Lean nystagmus and sitting to supine positioning nystagmus cannot be used alone in the diagnosis ofhorizontal semicircular canal benign paroxysmal positional vertigo. They need to be combined with supine roll test. However, when the supine roll test is difficult to demonstrate the affected side, it can be used as an auxiliary diagnostic method. When the results of 1ean nystagmus and sitting to supine positioning nystagmusand the supine roll test are inconsistent, repeat the test and conduct a comprehensive assessment to avoid missed diagnosis and misdiagnosis..

Color Doppler Ultrasonography Applied to Infertile Patients with Chronic Salpingitis and Mycoplasma Infection

Objective: To investigate the diagnostic value of color Doppler ultrasonography applied to infertile patients with chronic salpingitis and mycoplasma infection. Methods: 116 infertile patients with chronic salpingitis and mycoplasma infection were selected in this investigation. After these patients were admitted to hospital, they all underwent color Doppler ultrasound guided hysterosalpingogram and X-ray hysterosalpingography, in order to make definitive diagnoses, and the X-ray hysterosalpingography was considered as the gold standard. The diagnostic value and rates of adverse reaction between color Doppler ultrasound guided hysterosalpingogram and X-ray hysterosalpingography were evaluated. Results: A total of 116 patients with chronic salpingitis and mycoplasma infection received color Doppler ultrasound guided hysterosalpingogram and X-ray hysterosalpingography. Diagnostic coincidence rates were equal, and no statistical difference could be observed (P &gt; 0.05), with respect to the tubal patency in double sides, tubal obstruction in double sides, tubal patency in single side, and tubal obstruction in single side. When concerning adverse reactions, the incidence rates of allergy and colporrhagia between two groups were statistically significantly different (P = 0.025 and P = 0.040, respectively). In addition, the total incidence rate of adverse reactions was also statistically significant different (P = 0.003). Conclusion: The color Doppler ultrasound aided hysterosalpingogram could make a diagnosis intuitively and clearly for patients with chronic salpingitis and mycoplasma infection, and can be used as the preferred method for diagnosing tubal infertility.

Analysis of diagnostic value of multi-row spiral CT in thoracoabdominal joint injury

Objective To evaluate the diagnostic value of multi-slice spiral CT in thoracic and abdominal joint injury. Methods From January 2015 to January 2018, 200 patients with acute trauma were selected in the First Hospital of Yuncheng.Chest and abdomen X-ray examination and multi-row spiral CT examination were performed.The diagnostic sensitivity, specificity and accuracy of X-ray and spiral CT in the diagnosis of thoracoabdominal joint injury were calculated and compared.The coincidence rate of X-ray and spiral CT in diagnosis of rib fracture and intrathoracic and abdominal organ injury was compared.Consistency test was used to analyze the consistency between X-ray, spiral CT diagnosis and clinical comprehensive diagnosis. Results The sensitivity, specificity and accuracy of X-ray in the diagnosis of chest joint damage were 89.58%(129/144), 85.93%(47/56), 88.00%(176/200), respectively, which were lower than those of spiral CT[97.22%(140/144), 96.43%(54/56), 97.00%(194/200)](χ2=6.818, 4.940, 11.676, all P<0.05). The diagnostic coincidence rates of spiral CT for rib fracture, lung contusion, liver contusion, splenic rupture, pancreas injury and peritoneal injury were 97.67%(84/86), 97.06%(33/34), 100.00%(25/25), 100.00%(27/27), 100.00%(21/21), 97.96%(48/49), which were higher than those of X-ray(χ2=5.733, 3.981, 4.348, 5.510, 4.421, 5.995, all P<0.05). After consistency test, there was good consistency between spiral CT and clinical comprehensive diagnostic results(Kappa=0.747), and medium consistency between X-ray and clinical comprehensive diagnostic results(Kappa=0.563). Conclusion Multi-row spiral CT can be used to accurately diagnose the combined injury of chest and abdomen, as well as to identify the fracture of rib and the injury of internal organs and organs in the chest and abdominal cavity. Key words: Wounds and Injuries; Thoracic injuries; Abdominal injuries; Rib fractures; Cicatrix, hypertrophic; Radiography; Diagnosis; Comparative study

The value of oral contrast ultrasonography in the diagnosis of gastric cancer in elderly patients

BackgroundThis study aims to investigate the value of oral contrast ultrasonography (OCUS) in the diagnosis of gastric cancer in elderly patients.MethodsOCUS data obtained from patients ≥ 60 years old were retrospectively analyzed and compared with gastroscopy results.ResultsAmong the 12,716 subjects examined by OCUS, 5021 subjects were ≥ 60 years old, which accounted for 39.48% (5021/12,716). Gastritis, gastric polyp, benign ulcer, and gastric cancer were detected by OCUS in 1099 patients. Among them, 196 patients underwent gastroscopy. Furthermore, ulcerative lesions were detected in 32 patients by OCUS and in 51 patients by gastroscopy, and the coincidence rate was 62.74%. Among these patients, gastric cancer was diagnosed in 18 patients by OCUS with a detection rate of 1.64% (18/1099) and detected in 19 patients by gastroscopy with a diagnostic coincidence rate of 94.73% (18/19). Furthermore, benign ulcer was detected in 14 patients by OCUS and in 32 patients by gastroscopy, and the diagnostic coincidence rate was 43.75% (14/32).ConclusionOCUS helps to timely detect senile gastric cancer and can be used as a suitable technique for the detection of gastric diseases.

Contribution of the clinical information to the accuracy of the minimally invasive and the complete diagnostic autopsy

SummaryAlthough autopsy diagnosis includes routinely, a thorough evaluation of all available pathological results and also of any available clinical data, the contribution of this clinical information to the diagnostic yield of the autopsy has not been analyzed. We aimed to determine to which degree the use of clinical data improves the diagnostic accuracy of the complete diagnostic autopsy (CDA) and the minimally invasive autopsy (MIA), a simplified pathological postmortem procedure designed for low-income sites. A total of 264 coupled MIA and CDA procedures (112 adults, 57 maternal deaths, 54 children, and 41 neonates) were performed at the Maputo Hospital, Mozambique. We compared the diagnoses obtained by the MIA blind to clinical data (MIAb), the MIA adding the clinical information (MIAc), and the CDA blind to clinical information (CDAb), with the results of the gold standard, the CDA with clinical data, by comparing the International Classification of Diseases, Tenth Revision codes and the main diagnostic classes obtained with each evaluation strategy (MIAb, MIAc, CDAb, CDAc). The clinical data increased diagnostic coincidence to the MIAb with the gold standard in 30 (11%) of 264 cases and modified the CDAb diagnosis in 20 (8%) of 264 cases. The increase in concordance between MIAb and MIAc with the gold standard was significant in neonatal deaths (κ increasing from 0.404 to 0.618, P = .0271), adult deaths (κ increasing from 0.732 to 0.813, P = .0221), and maternal deaths (κ increasing from 0.485 to 0.836, 0.;P < .0001). In conclusion, the use of clinical information increases the precision of MIA and CDA and may strengthen the performance of the MIA in resource-limited settings.

Results analysis of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017

To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.

Diagnostic value of ultrasound combined with magnetic resonance imaging in different stages of breast cancer.

Diagnostic value of ultrasound (US) and magnetic resonance imaging (MRI) in breast cancer were investigated. One hundred and forty breast cancer patients diagnosed in Heping Hospital Affiliated to Changzhi Medical College from June 2016 to June 2018 were collected, used as breast cancer group, 80 patients with benign breast tumor in the same period were the benign group. Pathological results were used to compare the diagnostic coincidence of US and MRI in breast cancer patients. The positive expression case rates of estrogen receptor and progesterone receptor were significantly higher in breast cancer group than those in benign group, but that of human epidermal growth factor receptor 2 (Her-2) was significantly lower in breast cancer group than that in benign group (all P<0.05). The sensitivity (SEN) of MRI alone and that of US combined with MRI were higher than that of US alone (P<0.05). The specificity (SPE) of MRI alone was lower than that of US alone and US combined with MRI (P<0.05). The NPV of US combined with MRI was significantly higher than that of US alone (P<0.05). The Youden index (YI) of US combined with MRI was significantly higher than that of US alone and MRI alone. In the diagnosis of N2, that of US combined with MRI was significantly higher than those of US alone and MRI alone (P<0.05). In stages of M0 and M1 among three methods, those of MRI alone and US combined with MRI were higher than that of US alone (P<0.05). US combined with MRI for the diagnosis of breast cancer has higher SEN and SPE, with better accuracy rate for the identification of each stage. Reducing the incidence of missed diagnosis and misdiagnosis that may be caused by single diagnosis and treatment, it is conducive to clinical screening and guiding clinical symptomatic treatment.

Research on the learning curve of contrast-enhanced ultrasonography in sentinel lymph node of breast cancer

Objective To investigate the learning curve of contrast-enhanced ultrasonography (CEUS) in sentinel lymph node(SLN) of breast and provide a theoretical basis for leaners to learn SLN CEUS. Methods The multi-center study of SLN CEUS in breast cancer was planned by Sichuan Cancer Hospital. According to the uniform inclusion and exclusion criteria, 511 patients with complete clinical data and follow-up results from 9 hospitals in Multi-center were included in this study. According to the inspection time, the patients were divided into 3 groups named as group A (170 patients), group B (170 patients) and group C (171 patients), respectively. The basic clinical data, ultrasound imaging data, intraoperative and postoperative pathological findings of all patients were recorded. With the accumulation of cases examined, analysis was performed to find the learning curve of the SLN CEUS examination time, SLN CEUS detection rate, SLN CEUS surface marking accuracy rate and SLN CEUS diagnosis rate, the learning curve was analyzed. Results ①There was no statistical significant difference in patients ages, tumors sizes, tumors locations, SLNs numbers and LCs numbers among the three groups(all P>0.05). ②As the number of cases examined increases, the examination time was reduced gradually, but SLN detection rate, surface marking accuracy and SLN diagnostic coincidence rate were increased gradually(F=151.75, 1.96, 7.49, 5.50; P=0.000, 0.143, 0.001, 0.005). Conclusions The skill of the doctor is improved gradually when learning SLN CEUS. With the number of the cases increase, the operating time of SLN CEUS is shorted, and the SLN detection rate, surface marking accuracy and SLN diagnostic coincidence rate of SLN-CEUS are gradually increased. It has an important clinical significance for beginners to learn the SLN CEUS technology. Key words: Contrast-enhanced ultrasonography; Sentinel lymph node; Learning curve; Multicenter study

Diagnostic value of Fuji intelligent color enhancement on vocal leukoplakia and esophageal diseases

Objective To study the clinical application of Fuji intelligent color enhancement (FICE) on the diagnosis of vocal leukoplakia and esophageal diseases. Methods A total of 50 patients suspected with vocal leukoplakia by electronic laryngoscopy were enrolled for undergoing meticulous examination of vocal cords and esophagus using FICE from January 2014 to January 2016. The diagnostic value of FICE for vocal leukoplakia were analyzed. Results Among the 50 patients, 50 lesions were found using laryngoscopy and 52 lesions were found using FICE. There were significant differences between FICE mode and white light mode on the capillary pattern score and lesion boundary resolution score (all P<0.05). The diagnostic coincidence rate of FICE mode with pathology was higher than that of white light mode[89.4% (42/47) VS 68.1% (32/47), P=0.01]. Among the 50 patients suspected with vocal leukoplakia, 31 combined with gastroesophageal reflux disease, and were given proton-pump inhibitor treatment. In the follow-up after three months, lesions of 16 cases alleviated, 13 cases disappeared, and 2 cases had no significant changes. Conclusion FICE has a higher clinical value than conventional laryngoscopy and white light endoscopy on the diagnosis of vocal leukoplakia. Key words: Endoscopy; Diagnosis; Fuji intelligent color enhancement; Vocal leukoplakia; Esophageal diseases

Olfactory Dysfunction and Its Relationship with Clinical Symptoms of Alzheimer Disease.

Our study aimed to analyse the olfactory dysfunction (OD) evaluations between self-report, the Hyposmia Rating Scale (HRS) and the Sniffin’ Sticks test, and the relationship between OD and clinical features of AD. Sixty patients with AD dementia, 37 patients with mild cognitive impairment (MCI) due to AD and 30 healthy controls were consecutively recruited. Olfactory function was evaluated by self-report, HRS and Sniffin’ Sticks test. Patients were divided into AD with OD (AD-OD) and AD with no OD (AD-NOD) groups based on the results of the Sniffin’ Sticks test. Cognitive symptoms and neuropsychiatric symptoms were assessed by corresponding scales, and activities of daily living (ADL) were assessed by the ADL scale. In the control, MCI due to AD and AD dementia groups, the frequency of OD was 10.0%, 13.5% and 18.3%, respectively, by self-report; 6.7%, 24.3% and 48.3%, respectively, by HRS; and 3.3%, 13.5% and 65.0%, respectively, by the Sniffin’ Sticks test. Compared to the results of the Sniffin’ Sticks test, the diagnostic coincidence rates of OD by HRS in patients with MCI due to AD and AD dementia were 89.2% and 66.7%, respectively. Compared to the AD-NOD group, the scores of global cognition and memory, visuospatial ability and attention were all decreased (P<0.05), the apathy score was increased (P<0.05), and the ADL score was elevated (P<0.01). The frequency and accuracy of OD by self-report is relatively low. HRS can be used for screening olfaction in patients with MCI due to AD. The Sniffin’ Sticks test can be used for validating OD in AD patients. AD-OD patients have severe impairments in global cognition and multiple cognitive domains of memory, visuospatial ability and attention, as well as neuropsychiatric symptoms of apathy, and thus have seriously compromised ADL.

Clinical value of X-ray plain film in the diagnosis of early lung cancer

Objective To evaluate the diagnostic value of X ray film in early lung cancer. Methods 100 patients with pulmonary nodules were selected as the subjects.X-ray examination was performed.The histopathological findings were the gold standard.The diagnostic efficacy of X-ray plain film in early lung cancer was analyzed.The diagnostic accuracy, radiation dose and characteristics of lesions were compared between X ray and CT. Results 47 cases of lung cancer were diagnosed by X-ray plain film, 5 cases of benign lesions were diagnosed as malignant, and 9 cases of malignant lesions were diagnosed as benign.The diagnostic sensitivity, specificity, positive predictive rate, negative predictive rate and diagnostic coincidence rate were 83.9%, 88.6%, 90.4%, 81.3% and 86%, respectively.Comparison of X-ray and CT in the overall diagnosis of early lung cancer(86% vs 93%), the difference was not statistically significant(χ2=2.647, P>0.05). But the effective radiation dose of X ray radiography was lower than CT scan [(0.16±0.02)mGy/cm vs.(0.89±0.03)mGy/cm], the difference was statistically significant(t=10.475, P 0.05). But the X-ray film showed a significantly lower rate of grinding glass stove than CT(3.6% vs.16.1%), the difference was statistically significant(χ2=4.940, P<0.05). Conclusion X ray film has high diagnostic accuracy in the diagnosis of early lung cancer, and with low price, low radiation dose, it is suitable for routine screening. Key words: X-ray film; Lung tumor; Diagnosis

Analysis of correlation between gastroscopic manifestations and pathological diagnosis of chronic atrophic gastritis

Objective To investigate the correlation of endoscopic and pathological diagnosis of chronic atrophic gastritis(CAG). Methods 108 patients diagnosed as CAG by gastroscopy were selected.Whether the results were consistent with the diagnosis between gastroscope and pathology were observed, and the diagnosis relationship between gastroscopic and histopathological features, and the relationship between CAG and Hp were observed, and the coincidence rates of the diagnostic results by using these two methods were calculated. Results 19 cases of chronic superficial gastritis(CSG) and 89 cases of CAG were diagnosed by pathologic biopsy, and 42 cases of CAG with intestinal metaplasia, 13 cases with dysplasia.The coincidence rate of CAG between gastroscopic and pathological diagnosis was 82.41%.9 cases showed the gastric mucosa in rough and showed granular or nodular changes, meanwhile, 7 cases of them with CAG were confirmed by histopathology, following 3 cases of them with intestinal metaplasia(33.33%) and 1 case of them with heterosexual hyperplasia(11.11%).18 cases showed the change of the color of the gastric mucosa with red and white, and mainly in white, following vascular exposure tested by gastroscope.13 cases of them(72.22%) with CAG were confirmed by histopathology, 4 cases of them with intestinal metaplasia(22.22%) and 1 case of them with heterosexual hyperplasia(5.56%).14 cases showed gastric mucosal folds flat, thinning or even disappear tested by gastroscope.10 cases of them(71.43%) with CAG were confirmed by histopathology, following 4 cases of them with intestinal metaplasia(28.57%) and 2 cases of them with heterosexual hyperplasia(14.29%). When the three manifestations of gastroscope were presented, the CAG coincidence rate was more than 70.00%, and the highest was the rough gastric mucosa with the rate of 77.78%.When the any two of the manifestations of gastroscope were simultaneously presented, the CAG coincidence rate was more than 80.00%, and the highest was the rough gastric mucosa and the color of red and white combination with the rate of 88.00%.When the three of the manifestations of gastroscope were simultaneously presented, the CAG coincidence rate was more than 80.00%.Hp was positive in 55 cases(50.93%).89 cases were diagnosed by pathology, 48 cases of them(53.93%) were Hp positive.In the 42 cases with intestinal metaplasia, 24 cases of them(57.14%) were Hp positive.In 13 cases with dysplasia, 9 cases of them(69.23%) were Hp positive. Conclusion It should be combined with gastroscopy and pathological examination in clinic, and should pay more attention to the typical site biopsy and strengthen the identify of endoscopic morphology, and also standardize the endoscopic operation.It can ultimately improve the diagnostic coincidence rate of the two methods. Key words: Gastritis, atrophic; Gastroscopy; Pathology; Diagnosis

The value of bone marrow imprint in diagnosis of plasma cell myeloma and monitoring the remission after chemotherapy

Objective To investigate the value of bone marrow imprint in the diagnosis of plasma cell myeloma and the remission rate after chemotherapy. Methods Bone marrow aspiration, bone marrow imprint, and bone marrow biopsy of plasma cell myeloma with 128 patients were collected. The bone marrow biopsy was used as the standard. Bone marrow imprint was compared to bone marrow aspiration in bone marrow nucleated cells quantity, infiltration degree, and diagnostic coincidence rate. Sensitivity, specificity, positive predictive value, and Youden index were evaluated. Results The results of bone marrow imprint showed that the number of nucleated cells was better than that of bone marrow aspiration (P 0.05). Bone marrow biopsy combined with CD38 (+ ) showed the degree of infiltration of bone marrow as the standard, and the bone marrow imprint was better than that of bone marrow aspiration (P 0.05). To evaluate the compliance rate of bone marrow infiltration in bone marrow imprint: In phase I, the compliance rate of bone marrow aspiration was 95.83% (23/24) and bone marrow imprint of 91.67% (22/24), the difference was not statistically significant (P>0.05); In phase II, bone marrow imprint coincidence rate was 92.86% (65/70), which was significantly higher than that of bone marrow aspiration in 65.71% (46/70) (P<0.05); In phase III, bone marrow imprint coincidence rate was 79.41% (27/34), which was significantly higher than that of bone marrow aspiration in 44.12% (15/34) (P<0.05). The other parameters, such as sensitivity, specificity, positive predictive value, and Youden index were better than those of bone marrow aspiration. Conclusions Bone marrow imprint has characteristics that both bone marrow aspiration and bone marrow biopsy have. It has obvious advantages in diagnosis of plasma cell myeloma and monitoring the remission after chemotherapy. Key words: Bone marrow examination; Biopsy; Microtomy; Multiple myeloma/DI/DT

Application of contrast-enhanced ultrasound before inferior vena cava filter recovery.

This study aims to investigate the clinical value of contrast-enhanced ultrasound (CEU) before temporary inferior vena cava filter (IVCF) recovery in patients with deep venous thrombosis, in order to provide ultrasound signs for the recovery of IVCF in clinical practice. The CEU manifestations of patients with deep vein thrombosis before temporary IVCF recovery were retrospectively analyzed. With the manifestations of digital subtraction angiography (DSA) or results of the surgical recovery of IVCF as the standard, the detection rate of a thrombus in IVCF was compared between conventional ultrasound and CEU, and the role of CEU in detecting complications of IVCF was analyzed. In the 103 patients with IVCF, conventional ultrasound and CEU did not reveal any filter displacement and deformation, as well as infection. In 86 patients, filters were successfully recovered under DSA. In one patient, the filter was removed surgically. In 16 patients, recovery failed or was given up, and inferior vena cava (IVC) angiography was performed. The recovery rate of IVCF was 84.5%. Among all cases, thrombi were found within the filters or around the filter in 23 patients. The detection rate of thrombi was 47.8% (11/23) by conventional ultrasound and 82.6% (19/23) by CEU, and the difference between these two methods was statistically significant (P<0.05). CEU drew a misdiagnosis of thrombus within the filter in one patient, and the diagnosis was not confirmed after the recovery of the filter. The diagnostic coincidence rate of CEU for thrombus in the IVCF was 95.1%, and the positive predictive value was 95%. In another case, the foot of the IVCF pierced out of the wall of the IVC into the intestinal wall; and this was confirmed by DSA. Hence, recovery was given up. Thrombosis is the main complication after IVCF placement. CEU revealed typical manifestations of thrombi in the IVC, and has overcome the shortcoming of color Doppler ultrasound such as angular dependence. Its detection rate of thrombi within the IVCF was higher compared with conventional ultrasound. Hence, this method can serve as a simple and accurate method for evaluating whether IVCF is suitable for recovery. This study provides a reliable imaging basis for the clinical selection of the means and time of IVCF recovery, reducing unnecessary intervention procedure.