The diagnostic accuracy of rapid diagnostic tests for Ebola virus disease: a systematic review

BackgroundEbola virus disease (EVD) is a dangerous condition that can cause an epidemic. Several rapid diagnostic tests (RDTs) have been developed to diagnose EVD. These RDTs promise to be quicker and easier to use than the current reference standard diagnostic test, PCR.ObjectivesTo assess the diagnostic accuracy of RDTs for EVD.MethodsA systematic review of diagnostic accuracy studies.Data sourcesThe following bibliographic databases were searched from inception to present: MEDLINE (Ovid), Embase, Global Health, Cochrane Central Register of Controlled Trials, WHO Global Index Medicus database, Web of Science, PROSPERO register of Systematic Reviews, and Clinical Trials.Gov.Study eligibility criteriaDiagnostic accuracy studies.ParticipantsPatients presenting to the Ebola treatment units with symptoms of EVD.InterventionsRDTs; reference standard, RT-PCR.Assessment of risk of biasQuality Assessment of Diagnostic Accuracy Studies-2 tool.Methods of data synthesisSummary estimates of diagnostic accuracy study were produced for each device type. Subgroup analyses were performed for RDT type and specimen material. A sensitivity analysis was performed to assess the effect of trial design and bias.ResultsWe included 15 diagnostic accuracy studies. The summary estimate of sensitivity for lateral flow assays was 86.1% (95% CI, 86–86.2%), with specificity of 97% (95% CI, 96.1–97.9%). The summary estimate for rapid PCR devices was sensitivity of 96.2% (95% CI, 95.3–97.9%), with a specificity of 96.8% (95% CI, 95.3–97.9%). Pre-specified subgroup analyses demonstrated that RDTs were effective on a range of specimen material. Overall, the risk of bias throughout the included studies was low, but it was high in patient selection and uncertain in the flow and timing domains.ConclusionsRDTs possess both high sensitivity and specificity compared with RT-PCR among symptomatic patients presenting to the Ebola treatment units. Our findings support the use of RDTs as a ‘rule in’ test to expedite treatment and vaccination.     

神阙穴贴药对原发性骨质疏松症超声穿透速度的影响

目的：观察神阙穴贴补血益精透皮贴剂，对原发性骨质疏松症超声穿透速度（SOS）的影响。方法：选择原发性骨质疏松症患者130例。分4组治疗。即补血益精透皮贴剂组（A组），西药对照组（B组），补血益精药丸组（C组），空白对照组（D组）。结果：补血益精透皮贴剂组能显著提高超声穿透速度。结论：补血益精透皮贴剂组与补血益精药丸组和西药对照组对原发性骨质疏松症的调整作用基本一致。为治疗原发性骨质疏松症提供了一种新的方法。     

面口合谷收的形态学基础

目的：探讨合谷穴与口面部联系的形态学基础。方法：采用荧光素单标记和双标记法，将荧光素碘化丙啶（PI）和双苯甲亚胺（Bb)分别注入“合谷”穴区和“四白”穴区，取同侧脊神经节颈1-颈8，胸1-胸2，颈上，中，下交感节及三叉神经半月节，荧光显微镜下观察计数。结果：在脊神经节颈5-颈8观察到大量PI单标记细胞，主要分布于颈6-颈7，在三叉神经半月节也可见大量Bb单标记细胞，另外在三叉神经半月节可见少量PI-Bb以标记细胞，占标记细胞的4.5%。结论：三叉神经半月节有向“合谷”穴和“四白”穴的分支投射，这可能是“面口合谷收”的形态学基础。     

督脉穴为主治疗帕金森病临床分析

目的探讨针刺配合药物治疗帕金森病的可行性.方法针刺配合口服常规西药剂量的一半与常规西药剂量治疗进行对照研究.结果两组治疗前后差异均有非常显著性意义(P＜0.01),而两组治疗后比较,差异无显著性意义.结论针刺督脉穴为主治疗帕金森病有良好的疗效.     

不同取穴治疗肩周炎疗效对比

目的 :探讨治疗肩周炎的不同取穴方法。方法 :治疗组 50例 ,通过动诊结合局部组织解剖与病灶特点取穴 ;对照组 41例 ,采用传统循经取穴的方法。结果 :治疗组治愈率 66 0 % ,愈显率90 0 % ;对照组治愈率 34 1 % ,愈显率 73 1 %。两组治愈率及治愈者所需疗次间差异有非常显著性意义 (P <0 0 1 ) ,愈显率间差异有显著性意义 (P <0 0 5)。结论 :动诊及局部组织解剖特点相结合的取穴方法疗效较好     

傍刺天柱穴为主治疗颈性眩晕疗效观察

目的 :观察多针刺法与单刺法的效应差异。方法 :将 62例确诊为颈性眩晕的病人随机分为2组 :治疗组以傍刺天柱穴为主 ;对照组取穴与治疗组同 ,均按常规单刺 ,对治疗后 2组病人的主要症状进行评估 ,同时分别经颅脑多普勒检查 ,观察双侧椎动脉、椎 基底动脉的平均血流速。结果 :治疗后 2组均有显著疗效 (P <0 0 5) ;治疗后 2组椎动脉、椎 基底动脉平均血流速有明显改善 (P <0 0 1 ,P <0 0 5) ,2组间比较显示总有效率及颅脑多普勒指标差异均有显著性意义 (P <0 0 5)。结论 :傍针刺较单刺法在治疗颈性眩晕时更有效     

手十二井穴刺络放血对中风患者意识状态、心率等影响的临床观察

目的：观察手十二井穴刺络放血对中风初期患者意识状态等的影响。方法：以中风发病后3d有意识障碍的患者为观察对象，按病情分为损伤大面积、中面积、小面积3组，每组随机分为刺络组与对照组， 刺络组和对照组均进行正常治疗，仅刺络组增加井穴刺络放血。将意识状态进行量化，观察患者意识状态、血压、心率等的变化。结果：手十二井穴刺络放血可使损伤面积小的患者意识状态好转；收缩期血压上升；可使各组患者的心率加快。结论：手十二井穴刺络放血可使损伤面积小的患者意识状态好转。     

神阙穴敷贴对原发性骨质疏松症骨钙素的影响

目的　观察神阙穴贴补血益精透皮贴对原发性骨质疏松症骨钙素 (BGP)的影响。方法　选择原发性骨质疏松症患者130名 ,分神阙穴贴药组 (补血益精穴位透皮贴剂 )、西药组 (羟乙磷酸钠片 )、中药组 (补血益精药丸 )、空白对照组。结果和结论　穴位敷贴组能显著提高骨钙素 (7.69± 1.65 )。穴位敷贴组与中药组 (7.82± 0 .99)和西药对照组 (7.13± 0 .89)对原发性骨质疏松症的骨钙素调整作用基本一致 (P>0 .0 5 )。     

穴位注射治疗周围性面神经麻痹及肌电图观察

目的　观察穴位注射治疗周围性面神经麻痹的疗效。方法　将 80例患者分为穴位注射组 5 0例和对照组 30例 ,穴位注射组采用维生素 B1 2 及维生素 B1 注射液穴位注射 ,对照组采用常规针刺 ,观察两组疗效及治疗前后面部肌电图变化。结果与结论　穴位注射组治愈率及愈显率明显高于对照组 (P<0 .0 5 ,P<0 .0 1) ,治疗后穴位注射组募集电位改善情况较对照组明显为优 (P<0 .0 5 ,P<0 .0 1)。     

Treatment of 116 cases of facial pigmented spots by auricular needle-embedding method

以耳穴子宫、神门、内分泌、肺为主穴,根据辨证选取配穴,埋针治疗面部色素斑患者116例,全部治愈.