成人麻疹患者血清特异性IgM、IgG的表达与临床应用

课题针对目前临床成人轻型麻疹诊断难的情况,采用ELISA方法检测麻疹血清特异性IgM、IgG抗体。证实成人麻疹,尽管血清特异性IgM阳性是诊断麻疹的唯一依据,但一些患者血清特异性IgM始终阴性者,检测血清特异性IgG是较好的补充诊断方法。     

左心室肥厚心电图诊断标准分析

目的:对比左心室肥厚心电图诊断标准的敏感性和特异性,以评价不同标准的诊断价值.方法:分析364例原发性高血压患者的超声心动图及心电图检查结果.以超声心动图对患者左心室肥厚情况的检查结果为参照,求得不同心电图标准(Sokolow-Lyon标准、Comell标准、Romhilt-Estes评分、Framingham标准及Perugia标准)诊断左心室肥厚的敏感性和特异性.结果:5项心电图诊断标准的敏感性均＜50%;而特异性较高,除Perugia标准外,余4项标准均＞90%.Perugia标准的敏感性最高41%,特异性低89%;Sokolow-Lyon标准的敏感性22%及特异性93%均较低.结论:心电图诊断左心室肥厚的特异性高、敏感性稍差.Perugia标准是Comdl标准、左心室劳损改变、Romhilt-Estes评分等标准有机的结合,因此提高了心电图诊断的敏感性,而特异性未受到明显影响.     

彩色多普勒超声联合多排螺旋CT血管成像诊断主动脉夹层价值探讨

[摘要]目的：探讨主动脉夹层（Aortic dissection,AD）彩色多普勒超声和多排螺旋CT血管成像(MSCTA)的影像学表现及诊断价值。方法: 回顾性分析40例42人次AD的彩色多普勒超声和MSCTA影像学资料,按特异性和非特异性征象进行分析、对照,分析彩色多普勒超声及MSCTA对夹层诊断的准确率及特异性。结果: 40例42人次检查中,彩色多普勒超声诊断准确率100％,特异性为62.5％,MSCTA诊断准确率达100％,特异性达78.6%,二者联合应用诊断准确率达100％, 特异性达100％。结论：彩色多普勒超声和MSCTA各具优点,两者联合应用可为AD的诊断、预后评估、治疗方案的选择和术后随访提供准确的信息。     

检测华支睾吸虫特异性IgG4生物素-亲和素复合酶联免疫吸附法的建立及检测效能分析

目的探讨亲和素-生物素复合酶联免疫吸附法(ABC-ELISA)检测特异性Ig G4抗体用于诊断华支睾吸虫病的效果。方法建立检测华支睾吸虫特异性抗体Ig G4的ABC-ELISA法(Ig G4-ABC-ELISA),以此方法检测华支睾吸虫病、日本血吸虫病、卫氏并殖吸虫病、弓形虫病、棘球蚴病、囊尾蚴病和曼氏裂头蚴病患者血清样本。以Ig G4-ELISA和Ig GELISA法为对照,比较3种方法用于诊断华支睾吸虫病的敏感性、特异性、阳性预测值、阴性预测值及诊断效率。结果成功建立了用于检测华支睾吸虫特异性抗体的Ig G4-ABC-ELISA法,用此方法检测华支睾吸虫病患者血清特异性抗体Ig G4的敏感性为90.0%,特异性为98.2%,阳性预测值为93.8%,阴性预测值为97.0%,诊断效率为96.3%;Ig G4-ELISA法检测华支睾吸虫病患者血清特异性抗体敏感性为86.0%,特异性为98.2%,阳性预测值为93.5%,阴性预测值为95.9%,诊断效率为95.4%;Ig G-ELISA法检测华支睾吸虫病患者血清特异性抗体Ig G的敏感性为94.0%,特异性为88.1%,阳性预测值为70.1%,阴性预测值为98.0%,诊断效率为89.4%。Ig G4-ABC-ELISA法检测华支睾吸虫病患者血清特异性抗体的敏感性高于Ig G4-ELISA法(P0.05),特异性高于Ig G-ELISA法(P0.05)。结论 Ig G4-ABC-ELISA法检测华支睾吸虫特异性抗体IgG4具有高度敏感性与特异性,在华支睾吸虫病诊断中具有较好应用价值。     

心肌钙蛋白I检测对急性心肌梗死的诊断价值

长期以来 ,对急性心肌梗死 (AMI)的早期诊断缺乏特异性的检测手段 ,人们一直在寻求特异性高、敏感性强、诊断时域宽的诊断方法。有报道 ,新的生化指标肌钙蛋白 I(CTn I) ,对心肌细胞损伤的特异性很高。对此 ,我们同时检测 AMI患者血清中的 CTn I、肌酸磷酸激酶 (CK )及其同工酶     

门静脉癌栓影像学诊断的比较

比较术前各影像学检查对门静脉癌栓诊断的敏感性和特异性。回顾性分析110例肝细胞肝癌(HCC)伴门静脉癌栓患者的术前影像学特征及诊断。以同期100例HCC不伴门静脉癌栓患者为阴性对照。US、CT和MRL／MRA诊断门静脉癌栓的敏感性分别为88%、、93％和94％,其特异性分别为95％、96％和98％。经x2检验,各影像学诊断门静脉癌栓敏感性和特异性的差异无统计学意义(P>0．05)。各影像学检查对门静脉癌栓诊断的敏感性和特异性相近。     

常见胃粘膜病变的认识

1 胃炎的诊断对病理医生来说,胃粘膜活检诊断中的问题之一是判断正常粘膜与轻度炎症。在胃炎的分类中,有一种分类为特异性胃炎和非特异性胃炎,所谓特异性,是指急性出血性胃炎、肉芽肿性胃炎等有特异诊断的胃炎,这种胃炎与正常胃组织不易混淆。所谓非特异     

流行性出血热诊断研究进展

流行性出血热(EHF)过去无特异性血清学诊断方法,因而典型病人的诊断必须具备发热、出血和肾脏损害。1978年 Lee 等报道间接免疫荧光试验用于 EHF 诊断后,各种特异性血清学诊断方法不断建立,因而对其临床诊断有了进一步的认识。     

神经元特异性烯醇酶对小细胞肺癌的诊断价值

肺癌是目前常见的恶性病,它的诊断指标有多种,本文就灵敏度、特异性均较高的神经元特异性烯醇酶在肺癌诊断中的价值作一综述。     

三种无创检查方法诊断冠心病的价值

目的16层螺旋CT(16-SCT)、12导联动态心电图(AECG)和平板运动试验(EET)三种无创性诊断冠心病方法进行比较,并以冠状动脉造影(CAG)为金标准",评价其对冠心病的诊断价值。方法60例患者均行16-SCT、12导联AECG、EET和CAG检查。计算16-SCT、AECG、EET诊断冠心病的灵敏度、特异性。结果根据CAG结果,16-SCT诊断冠状动脉狭窄的灵敏度、特异性和准确率分别为91.0%,90.1%,90.4%;AECG诊断心肌缺血的灵敏度、特异性分别为54.8%,66.7%;EET诊断冠心病心肌缺血灵敏度、特异性为69.0%,72.2%。16-SCT与AECG及16-SCT与EET联合检测可使灵敏度提高到92.9%和95.2%,16-SCT与AECG、EET串联可使特异性提高到94.4%。结论16-SCT是一项新的有发展前途的冠心病诊断方法,能通过高的空间分辩率结合心电门控技术有效诊断冠心病,并结合AECG、EET检查提高冠心病的检出率。     

心肌肌钙蛋白Ⅰ在非ST段抬高型急性冠脉综合征的应用

心肌肌钙蛋白Ⅰ是作为心肌细胞特异性蛋白,同其它检验指标相比,具有出现时间早、诊断窗口期宽、特异性强、诊断阈值明确及检测快速等优点,被广泛应用于非ST段抬高型急性冠脉综合征的临床实践中。     

The diagnosis of polycythemia vera: new tests and old dictums

Pathogenetically fundamental observations have identified polycythemia vera (PV) as a clonal stem cell disease with bone marrow histological and other biological features that distinctly differentiate it from other causes of 'increased' hematocrit. However, relatively little attention has been given to the effective utilization of pathology and laboratory markers of clonal myeloproliferation as diagnostic tools in PV. In contrast, the diagnostic use of red cell mass (RCM) measurement in PV stemmed from the accidental endorsement, as 'diagnostic criteria', of 'study eligibility criteria' that were formulated for clinical trials. It has since become evident that RCM measurement is a tedious procedure that is fraught with multiple-level imprecision, as well as suboptimal diagnostic accuracy. Therefore, it is reasonable to consider dispensing with RCM measurement as a diagnostic test for PV and instead utilize a diagnostic algorithm that combines clinical information with easily accessible laboratory data, including serum erythropoietin level and bone marrow histology. Recent discoveries of myeloproliferative-disease-specific molecular markers, including the JAK2 V617F tyrosine kinase mutation that is found in the majority of patients with PV, provide further support for such a measure.     

The Role of CT and MRI in the Diagnosis of Chronic Rhinosinusitis

Chronic rhinosinusitis (CRS) is one of the most common chronic disease conditions in the United States. Currently, diagnosis is based initially on clinical symptomatology and signs, but the final diagnosis of CRS should be confirmed by objective measures. CT of the paranasal sinuses is the most commonly obtained test to confirm or exclude a diagnosis of CRS. CT has been shown to be reliable, accurate, and effective in diagnosing CRS, but it also imparts radiation exposure. More recently, MRI of the paranasal sinuses has been explored as a diagnostic modality in CRS. Initial data suggest it may be a viable alternative to CT in the diagnosis of CRS. As clinicians are likely to begin to use MRI as a diagnostic modality in CRS, further studies are warranted with respect to its particular diagnostic validation.     

Comment on “Artificial intelligence in gastroenterology: A state-of-the-art review”

Colon capsule endoscopy (CCE) was introduced nearly two decades ago. Initially, it was limited by poor image quality and short battery time, but due to technical improvements, it has become an equal diagnostic alternative to optical colonoscopy (OC). Hastened by the coronavirus disease 2019 pandemic, CCE has been introduced in clinical practice to relieve overburdened endoscopy units and move investigations to out-patient clinics. A wider adoption of CCE would be bolstered by positive patient experience, as it offers a diagnostic investigation that is not inferior to other modalities. The shortcomings of CCE include its inability to differentiate adenomatous polyps from hyperplastic polyps. Solving this issue would improve the stratification of patients for polyp removal. Artificial intelligence (AI) has shown promising results in polyp detection and characterization to minimize incomplete CCEs and avoid needless examinations. Onboard AI appears to be a needed application to enable near-real-time decision-making in order to diminish patient waiting times and avoid superfluous subsequent OCs. With this letter, we discuss the potential and role of AI in CCE as a diagnostic tool for the large bowel.     

提高胃肠胰腺神经内分泌肿瘤的诊断率——胃肠激素临床研究进展

胃肠胰腺神经内分泌肿瘤（GEP—NETs）是少见病．且诊断难度大。随着各种生化、影像以及内镜检查技术的发展．其诊断率不断提高。嗜铬粒蛋白A作为GEP—NETs的“通用”肿瘤标志物．其诊断敏感性和特异性为70％～95％。生长抑素受体显像大大提高了肿瘤的定位诊断率和鉴别诊断：内镜超声技术的应用将进一步提高直径〈1cm肿瘤的定位，结合术中超声技术可进一步提高GEP—NETs的定位诊断。针对上述诊断技术不敏感的GEP—NETs．随着对肿瘤胃肠激素研究的进展。将有望开发出更多特异性或敏感性高的诊断方法。     

The epidemiologic and clinical importance of norovirus infection

Noroviruses are a major cause of sporadic cases and epidemic outbreaks of gastroenteritis. The development of molecular diagnostic assays has led to an increased recognition of the significance of these viruses as causes of gastroenteritis in all age groups. This article reviews the epidemiology, clinical manifestations and pathogenesis of norovirus infection, and it describes the diagnostic and therapeutic approaches to this disease.     

A hundred years of progress in electrocardiography. 2: The rise and decline of vectorcardiography

Throughout the 20th century electrocardiography has been almost exclusively preoccupied by the single dipole concept as a model to account for body surface manifestations of cardiac electrical activity. Vectorcardiography, based on the single dipole approximation as an equivalent cardiac generator, has prevailed for over one half of this century as one of the most prominent components of electrocardiographic research. In retrospect, vectorcardiography has had conceptually an important impact on the progress in electrocardiography although it never became widely used in clinical practice. Recent comparative studies have confirmed that the diagnostic information contents of the standard 12-lead electrocardiogram and the vectorcardiogram are practically identical if adequately powerful, identical diagnostic classification procedures are used in extracting diagnostic information. After serving a useful role as a conceptual model, vectorcardiography is gradually fading away, being replaced by more realistic cardiac source models and by body surface leads supplementing in a better way the information content of the standard ECG leads.     

Chiari network: A case report and brief overview

The Chiari network is mobile, net-like structures occasionally seen in right atrium near the opening of inferior vena cava and coronary sinus. This is usually of no clinical significance and is often diagnosed incidentally. However, sometimes it may cause diagnostic confusion with right atrial pathologies, and may favour thromboembolism by causing flow obstruction. It may be associated with infective endocarditis, arrhythmias, and migraine. Sometimes, it acts as a physical barrier during invasive procedures. The Chiari network has also been described to protect from pulmonary embolism by acting as an inferior vena cava filter due to its sieve-like effect at the cavo-atrial junction. Here, the Chiari network has been described in a case of Ebstein anomaly of tricuspid valve which produced diagnostic confusion during echocardiography. A brief overview has also been presented.     

A hundred years of progress in electrocardiography 2: The rise and decline of vectorcardiography

ABSTRACT: Throughout the 20th century electrocardiography has been almost exclusively preoccupied by the single dipole concept as a model to account for body surface manifestations of cardiac electrical activity. Vectorcardiography, based on the single dipole approximation as an equivalent cardiac generator, has prevailed for over one half of this century as one of the most prominent components of electrocardiographic research. In retrospect, vectorcardiography has had conceptually an important impact on the progress in electrocardiography although it never became widely used in clinical practice. Recent comparative studies have confirmed that the diagnostic information contents of the standard 12-lead electrocardiogram and the vectorcardiogram are practically identical if adequately powerful, identical diagnostic classification procedures are used in extracting diagnostic information. After serving a useful role as a conceptual model, vectorcardiography is gradually fading away, being replaced by more realistic cardiac source models and by body surface leads supplementing in a better way the information content of the standard ECG leads.     

Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el empleo de la ecografía abdominal en la enfermedad inflamatoria intestinal

Ultrasound has an excellent diagnostic performance when Crohn's disease is suspected, when performing an activity assessment, or determining the extension and location of Crohn's disease, very similar to other examinations such as MRI or CT. It has a good correlation with endoscopic lesions and allows the detection of complications such as strictures, fistulas or abscesses. It complements colonoscopy in the diagnosis and, given its tolerance, cost and immediacy, it can be considered as a good tool for disease monitoring. In ulcerative colitis, its role is less relevant, being limited to assessing the extent and activity when it is not possible with other diagnostic techniques or if there are doubts with these. Despite its advantages, its use in inflammatory bowel disease (IBD) is not widespread in Spain. For this reason, this document reviews the advantages and disadvantages of the technique to promote knowledge about it and implementation of it in IBD Units.