Value Of Diagnostic Indicators Research Articles

The diagnostic value of cognitive assessment indicators for mild cognitive impairment (MCI)

Objective This study aims to evaluate and analyze the standard diagnostic methods for mild cognitive impairment (MCI). Methods This study used a prospective case-control study to examine baseline data and diagnostic indicators in a population of elderly with MCI. Based on different cognitive abilities, this study divided MCI and healthy control groups. The diagnostic indicators included CDT, MOCA, MMSE, PSQI, MBI, DST, HAMD, AD-related blood markers, and olfactory testing. The diagnostic value of each indicator was done using the ROC curve. Results This study included 240 adult participants, 135 in the health group and 105 in the MCI group. A comparison of baseline data revealed statistically significant differences between the two groups regarding age, blood glucose, MMSE, CTD, MOCA, ability to perform daily living, AD-related blood indices and olfactory tests (all p < 0.05). Logistic regression analysis statistically showed that age, MOCA, and CDT were independent diagnostic factors for MCI (all p < 0.05). Combining these three indicators has the best diagnostic specificity (92.54%). AD-related blood and olfactory tests indices had only moderate diagnostic values (AUC: 0.7–0.8). Conclusion Age, MOCA, and CDT are good indicators for diagnosing early-stage MCI. AD-related blood indices and olfactory tests can serve as valuable adjuncts in diagnosing MCI.

The potential value of plasma receptor interacting protein 3 in neonates with culture-positive late-onset sepsis

BackgroundLate-onset sepsis (LOS) is a systemic inflammatory response syndrome in neonates, and the molecular mechanism of LOS is incompletely characterized. The purpose of this study was to explore the potential value of receptor interacting protein 3 (RIP3) in LOS.Methods63 neonates with LOS supported by positive culture and 79 neonates without sepsis were enrolled in this study from September 2019 to March 2021. Plasma RIP3 was detected by enzyme-linked immunosorbent assay (ELISA) and assessed along with the whole blood hypersensitive C-reactive protein (hs-CRP) level and platelet count (PLT). Differences in RIP3, hs-CRP and PLT between the two groups were compared. Changes in the three indicators in sepsis were also observed after treatment. The diagnostic value of indicators for LOS was evaluated by receiver operating characteristic (ROC) curve analysis.ResultsIn the sepsis group, RIP3 and hs-CRP levels were significantly higher than those in the control group (RIP3, p < 0.0001; hs-CRP, p < 0.0001), and PLT was significantly lower than that in the control group (p < 0.0001). After treatment, RIP3 and hs-CRP levels among septic survivors were significantly decreased (p < 0.0001) and PLT significantly improved (p = 0.0216). With RIP3 > 15,845.19 pg/mL, hs-CRP > 5.00 mg/L, and PLT < 204.00 × 109/L as the positive criteria, the sensitivity values of the three indicators in the diagnosis of LOS were 69.8%, 60.3%, 60.3%, respectively, and the specificity values were 92.4%, 96.2%, 79.8%, respectively. The combination of RIP3, hs-CRP and PLT had a sensitivity of 77.8% and specificity of 97.5%.ConclusionsRIP3 may contribute to the early diagnosis of LOS and monitoring of treatment effect. The combined detection of RIP3, hs-CRP and PLT may be more effective than individual detection in the diagnosis of LOS.

Достовірні і сумнівні діагностичні критерії раннього неонатального сепсису

Neonatal sepsis is a significant cause of mortality among newborns, especially in low and middle income countries with poor economic development. It is important to start the appropriate treatment as soon as possible, as this prevents most deaths from sepsis and reduces the occurrence of residual neurological lesions due to septic meningitis. The article provides an overview of modern literature data on the principles of diagnosis of early neonatal sepsis; mentions the main etiological factors and ways of infection by potential pathogens. Diagnostic criteria for early neonatal sepsis have been analyzed and have been classified as doubt-ful or credible. An important role is given to the assessment of potential risk factors for the development of the septic process, including data on history of pregnancy and childbirth, clinical and laboratory indicators of the baby after birth. The nonspecificity of most clinical signs of sepsis and their comparison with clinical manifestations in meningitis was carried out. The importance of the bacteriological method of detecting the pathogen in the blood, urine and cerebrospinal fluid was analyzed, which remains the «gold» standard diagnosis of neonatal sepsis, and the method of multiplex polymerase chain reaction. There is a need to detect sepsis through visual examination, such as chest radiography, computed tomography, magnetic resonance imaging and ltrasonography of the head. The diagnostic value of indicators is described with the complete blood cell count and differential, including some of its components, and markers of inflammatory process, especially the immature-to-total (I/T) neutrophil ratio, C-reactive protein, procalcitonin. The article mentions a method of determining the concentration of immunoglobulin M in the serum, the elevated level of which indicates intrauterine infection. The diagnostic value of glutathione is considered, which is a marker of the functioning of the immune system. Emphasis is placed on the expediency of using Kaiser Permanente calculator to detect signs of sepsis in the first days of a newborn's life and the choice of optimal tactics management in such patients. No conflict of interest was declared by the authors. Key words: sepsis, newborn, diagnosis of infection, neonatal.

Diagnostic significance of non-specific diagnostic indicators for bacterial neonatal late-onset sepsis

Objective To investigate the diagnostic value of non-specific diagnostic indicators for bacterial neonatal late-onset sepsis. Methods A total of 55 children with bacterial neonatal late-onset sepsis in Langfang People's Hospital were selected as sepsis group.Another 67 cases of non-infected newborns were selected as control group.White blood cell, platelet and C-reactive protein were retrospectively analyzed for diagnostic value.Meanwhile, percentage of neutrophils and mean platelet volume were analyzed for diagnostic value. Results When the bacterial neonatal late-onset sepsis occurred, the sensitivity(41.8%), specificity(95.6%) and positive predictive value(92.0%) of C-reactive protein were high.The sensitivity(18.2%, 10.9%), positive predictive value(71.4%, 85.7%) of white blood cell and platelet were low, but specificity(94%, 98.5%) was high.The percentage of neutrophils [(62.01±22.16)] and mean platelet volume[(11.60±0.98)] were higher than those of the control group [(36.58±11.06), (10.88±0.95)], and the differences were statistically significant(all P<0.05). Conclusion C-reactive protein has greater diagnostic value for bacterial neonatal late-onset sepsis.The percentage of neutrophils and mean platelet volume have some diagnostic value. Key words: Sepsis; Bacterial; Late-onset; White blood cell; Platelet; C-reactive protein; Percentage of neutrophils; Mean platelet volume; Infant, newbow

Clinical application value of thrombela-stogram for anticoagulant therapy to prevent deep venous thrombosis in perioperative period of Orthopedics Department

Objective To research the clinical application effect of thrombela-stogram(TEG) for anticoagulant therapy to prevent deep venous thrombosis(DVT) in perioperative period of Orthopedics Department. Methods Sixty-eight cases of fracture patients treated with surgery in the Orthopedicsin Department of Jiangning Hospital of Nanjing were selected as the research subjects, and 42 healthy volunteers for a physical examination at the same period were selected as the control group.All fracture patients were treated with anticoagulant therapy after surgery, according to the different anticoagulants, the fracture patients were divided into the low molecular weight heparin(LWMH) group and the rivaroxaban group.On the day of the investigation, the control group was detected by TEG, and the TEG test was performed on all the patients during the perioperative period. Results There was no significant difference on the TEG test results between fracture patients and the control group(P>0.05), the TEG test results of fracture patients were normal, and the blood was not in the high coagulation state.On the 7th d of anticoagulant therapy and the end of anticoagulant therapy, the R value in the LWMH group and in the rivaroxaban group were the highest positive rate, were all more than 50%.At the end of the anticoagulant therapy, the abnormal detection rate of α angle, maximum thrombus(MA) and integrated coagulation index(CI) in the rivaroxaban group were 35.29%, 32.35%, 41.76%, respectively, were significantly higher than those in the LWMH group(8.82%, 17.65%, 11.76%), the differences were statistically significant(χ2=6.9283, 5.7566, 7.5556, P<0.05). After the end of the anticoagulant therapy for Doppler ultrasound, 9 cases were diagnosed as DVT, and the incidence rate was 14.06%.Compared and founded, at the end of the anti coagulation therapy, the great value of the diagnostic indicators were α angle, MA and CI, the sensitivity was 64.71%, 76.47%, 73.53% respectively, and the specificity was 79.41%, 73.53%, 82.35% respectively. Conclusion After fracture surgery, the coagulation function of the patients are changed, using TEG dynamic detection can accurately understand the change of blood state in real time, and it has important reference value for the evaluation of blood coagulation function.With MA was equal to 68.35 mm as a clinical diagnosis of critical point. Key words: Thrombela-stogram; Perioperative period of department of orthopedics; Anticoagulant therapy; Deep venous thrombosis