Objective To evaluate the application of tendency-oriented perimetry (TOP) in detecting the visual function of glaucoma. Methods The traditional threshold perimetry (Normal/Normal strategy) and TOP (TOP/Normal strategy) carried out by Octopus 101 perimetry were used to examine the visual field of 20 normal subjects (20 eyes), 32 cases (32 eyes) of primary open-angle glaucoma (POAG), and 14 cases (14 eyes) of suspected POAG, respectively. The visual field outcomes, indices, point by point threshold variability and defective points of the two perimetries were compared and analysed. Results The negative rate of TOP was 90% in normal subjects. The positive rate of TOP was 75% in POAG , and 100% in middle and late stage of POAG. The visual field indices of two perimetries were positively correlated, with mean sensitivity (MS) of r=0.9335, mean defect (MD) of r=0.9189, and loss variance (LV) of r=0.9621. The point by point threshold variability and defective points of TOP were higher than those of traditional threshold perimetry, but the difference between the two perimetries was not significant (P=0.2019, P=0.4448). Conclusion The visual field indices of TOP and traditional threshold perimetry are positively correlated. The sensitivity and reproducibility of TOP are high in detecting the visual function of middle and late stage of POAG. (Chin J Ocul Fundus,Dis, 2002, 18: 269-272)
Objective To study the significance of detection the short-term fluctuation (SF) of macular light threshold detected by Octopus-123 automatic perimeter in suspected early age-related macular dege-neration (AMD). Methods SF of macular light sensitivity, Amsler chart and central visual acuity were examined in 51 patients(66 eyes) with suspected early AMD group and in 32 patients (40 eyes) in the control group. Results SF were significantly different in suspected early AMD group and control group. SF was more sensitive than the examination of central visual acuity and Amsler chart. SF was related to the quantity, location and quality of drusen. Conclusion Visual function of some suspected early AMD patients with drusen may be damaged, though the central visual acuity appears normal. (Chin J Ocul Fundus Dis, 2002, 18: 119-120)
ObjectiveTo systematically review clinical value of des-γ-carboxy prothrombin (DCP) in the diagnostic of primary hepatocellular carcinoma (PHC).MethodsDatabases including PubMed, The Cochrane Library, EMbase, Medline (Ovid), CNKI, VIP, WanFang Data and CBM were electronically searched to collect relevant studies on DCP in the diagnosis of PHC from inception to December 31st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Meta-Disc 1.4 software and RevMan 5.3 software.ResultsA total of 50 studies involving 15 099 cases were included. The results of meta-analysis showed that the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio and area under the curve of SROC were 0.69 (95%CI 0.67 to 0.70), 0.89 (95%CI 0.89 to 0.90), 7.35 (95%CI 6.08 to 8.90), 0.31 (95%CI 0.27 to 0.35), 26.63 (95%CI 20.42 to 34.73) and 0.909 9, respectively.ConclusionsSerum DCP has higher diagnostic efficacy for PHC, especially with higher specificity of diagnosis. Due to the limited quality and quantity of included studies, the above results should be validated by more studies.
Objective To evaluate the variability of four parameters of multi-focal electroretinogram (mERG) a-wave amplitude, b-wave amplitude, awave latent period, b-wave latent period. Methods Sixty normal eyes of 46 volunteers were divided into 3 groups of different ages. RETIscan 3-12 system was used to carry out mERG examination. The stimulus matrix of 61 hexagonal elements spanning the central 24deg;of the visual field. These hexons were scaled with eccentricity and divide d into 5 rings. First-order kernel was selected. Results The variability of four parameters of mERG was great. The variability of b-wave latent period was the smallest, its coefficient of variatian was 4.52%～15.62%；that of a-wave latent period held the second place:10.29%~48.67%；that of b-wave amplitude was greater:25.92%~76.11%；that of a-wave amplitude was the greatest:43.82%~88.23%. The results of three groups showed that b-wave amplitude of ring 1 had the smallest variability. Conclusions The variability of latent period is smaller than that of amplitude; the variability of b-wave was smaller than that of a-wave. The longer the centrifugal distance, the lower the amplitude density of a-wave and b-wave. Physiological and anatomical factors might be important for the variability of parameters of multi-focal electroretinogram. (Chin J Ocul Fundus Dis, 2001,17:277-279)
摘要:目的:动态监测急性胰腺炎(AP)患者外周血C反应蛋白(CRP)水平,探讨CRP对AP的早期诊断与病情评估的参考价值。方法:分别检测75例SAP患者和75例 MAP患者入院后第1、3、5、7、9天外周血CRP水平,并进行分析比较。结果: MAP组患者CRP高峰值出现在住院第3天,第7天开始下降,14天后恢复正常。而SAP组患者住院第1天即可出现CRP显著增高,且下降速度缓慢,在后期CRP仍可维持在一个较高水平。入院第1天,SAP组血清CRP水平均显著高于MAP组(Plt;0.01)。轻症与重症组(无并发症或有并发症)之间患者血清CRP水平差异均有高度显著性(Plt;0.01)。结论: 动态监测CRP可作为AP早期诊断、疾病严重程度评估及预后判断的一个独立的衡量指标,值得临床推广应用。Abstract: Objective: To dynamic monitoring of acute pancreatitis (AP) in patients with Creactive protein (CRP) levels, CRP on the AP to explore the early diagnosis and prognostic evaluation of the reference value. Methods: 75 cases of SAP patients were examined and 75 patients with mild acute pancreatitis (MAP) after admission in patients with CRP levels in peripheral blood 1,3,5,7,9 days, and conduct analysis and comparison of. Results:MAP peak value of CRP in patients in hospital the first 3 days, 7 day drop in 14 days after return to normal. The SAP Group 1st day of hospitalization was significantly higher CRP can occur, and the rate of decline is slow, in the latter part of CRP can be maintained at a high level. Admission day 1, SAP serum levels of CRP were significantly higher than the MAP group (Plt;0.01). Between mild and severe group, no complications and complications in patients with serum CRP levels of SAP differences were highly significant (Plt;0.01). Conclusion:Dynamic monitoring of CRP can be used as AP early diagnosis, disease severity assessment and prognosis of an independent measure worthy of clinical application.
ObjectiveTo analyze the relationship between maximum standardized uptake value (SUVmax) of primary tumor detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) and clinicopathologic factors in stageⅠnon-small cell lung cancer (NSCLC), and investigate the prognostic value of PET/CT on pathological feature. MethodsWe retrospectively analyzed clinical data of 182 patients with stageⅠNSCLC who underwent 18F-FDG PET/CT scan before lobectomy or segmentectomy in China-Japan Friendship Hospital from April 2013 to June 2014. There were 121 male and 61 female patients with their ages of 34-85 (68.1±9.8) years. Clinicopathologic factors including sex, age, smoking history, histology, TNM stage, T stage, tumor size, lymphatic vessel invasion, blood vessel invasion (BVI) and visceral pleural invasion were evaluated to identify the independent factors affecting SUVmax by univariate and multivariate regression analysis. The diagnostic efficiency and best cut-off point of SUVmax were calculated by the receiver operating characteristic curve. ResultsThe univariate analysis identified that sex (P=0.015), smoking history (P=0.001), histology (P < 0.001), TNM stage (P=0.004), T stage (P=0.001), tumor size (P < 0.001), BVI (P=0.001) were factors affecting SUVmax. Only histology (P=0.001), tumor size (P=0.006), BVI (P=0.009) were found to be significant independent factors according to multivariate regression analysis. The SUVmax of primary tumor was a predictor for BVI with the highest diagnostic accuracy at a cut-off value of 4.85, the sensitivity and specificity were 65.5% and 71.7%. ConclusionThe SUVmax is correlated with histology, tumor size and BVI in stageⅠNSCLC, higher in patients with non-adenocarcinoma, lager tumor and positive BVI. Furthermore, the probability of BVI could be predicted by SUVmax of the primary tumor.
Patient values and preferences is one of the elements of evidence-based medicine research, which is also an important part that should be considered in the development of evidence-based guidelines in the present and future. However, the research in this field in China has just begun. This article gives a brief introduction of its concepts, methods, influence factors based on the international researches of patient values and preferences and a brief description of the development in China, in order to provide references for the development of evidence-based guidelines based on the consideration of patient values and preferences in the future.
Objective To analyze the risk factors of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) and to explore the effective index of predicting POPF after DP. Methods The clinical data of 120 patients with pancreatic disease who were treated with DP in the Department of Tumor Surgery of Xuzhou Medical University from January 2010 to November 2017 were analyzed retrospectively. The influencing factors of POPF after DP were analyzed by non-conditional logistic regression. Results Of the 120 patients, 15 patients (12.5%) had clinically significant POPF, including 13 cases of grade B pancreatic fistula and 2 cases of grade C pancreatic fistula. The results of non-conditional logistic regression showed that, the soft pancreas and preoperative pancreatic CT value of the pancreas less than 40 Hu were the independent risk factors of POPF after DP (P<0.05). Conclusions Pancreatic texture and preoperative CT value are important factors influencing the occurrence of POPF after DP. Evaluating the preoperative CT value and intraoperative pancreatic texture can effectively predict the risk of POPF after DP.
ObjectiveTo investigate the value of esophageal activity examination under X-ray fluoroscopy and chest CT in evaluating the resectability of upper thoracic esophageal cancer.MethodsA total of 221 upper thoracic esophageal carcinoma patients underwent radical operation between 2009 and 2015 in our hospital were enrolled, including 141 males and 80 females with a median age of 59 (47-79) years. Preoperative routine esophageal activity examination under X-ray fluoroscopy and chest enhanced CT were performed to determine whether the tumor had external invasion. The results of the two methods were compared with that observed during the operation.ResultsThe number of patients with esophageal activity score 1-6 was 70, 85, 32, 29, 2 and 3, respectively. The area under the receiver operating characteristic (ROC) curve (AUC) of esophageal activity examination was 0.897 (95%CI 0.85-0.93, P<0.001), and the cut off value was >3. According to the ROC curve activity score, 4-6 points were considered as invasion, and 1-3 points were non-invasion. The sensitivity, specificity, accuracy and misdiagnosis rate of esophageal activity examination was 75.0%, 89.3%, 88.2%, 10.7%, respectively, and those of CT scan were 75.0%, 66.8%, 67.4%, 33.2%, respectively. Compared with CT scan, the specificity of esophageal activity examination was higher and the misdiagnosis rate was lower. Compared with the detection during the operation, 86.7% of patients with actual invasion of trachea and 85.7% of patients with actual invasion of other parts were in accordance with the esophageal activity examination results.ConclusionEsophageal activity examination under X-ray fluoroscopy can accurately predict the resectability of upper thoracic esophageal cancer, which is a useful supplement to chest CT examination, especially in the aspect of judging the relationship between lesions and the trachea.
Objective To assess the quality of current domestic literature about enzyme-linked immunosorbent assay (ELISA) for invasive aspergillosis diagnosis by detecting Aspergillus galactomannan (GM) antigen, and to analyze the sources of bias and variability, as well as the diagnostic ability of different thresholds. Methods Both computer-based online search and manual retrieval were employed to identify relevant articles. The statistical information and quality of science were assessed and classified. The data were analyzed using Meta Disc 1.4 software. The best cutoff value for defining a positive test result was selected by summarizing the following statistical indicators as sensitivity, specificity, likelihood ratio (LR) and summary receiver operating characteristic curve (SROC curve), and by calculating the area under the curve (AUC) as well. Results A total of 20 studies among 2658 literatures were included in accordance with the inclusion criteria, and were divided into different groups based on different cutoff values. Though heterogeneity tests showed no threshold effect, and there were other reasons of heterogeneity. So the data were analyzed by random effects model. The results showed that, compared with other groups, the one with cutoff value set at 0.7 (AUC=0.9456, Q= 0.884 6) showed the best accuracy in diagnosing. Conclusion ELISA detection of Aspergillus GM antigen with cutoff value set at 0.7 has important significance in the early diagnosis of invasive aspergillosis, and it can be conducive to reduce mortality in patients at high risk for Aspergillus infection.