Upper limb neurodynamic test 1 in patients with clinical diagnosis of carpal tunnel syndrome: A diagnostic accuracy study

Study Design

Diagnostic accuracy.

Relevance of autoantibody detection to the rapid diagnosis of brucellosis

The rose bengal test is often used for rapid diagnosis of human brucellosis in endemic areas. However, autoantibodies have never been investigated as a reason for false-positive or false-negative results. Therefore, the aim of this study was to show the effect of autoantibody detection on the rapid diagnosis of human brucellosis in an endemic area. The study included 2 groups: antinuclear antibody (ANA)-positive and ANA-negative groups. Diagnosis of brucellosis was established by isolation of Brucella spp. from blood culture. The overall sensitivity and specificity of the rose bengal test were 100% and 90.8%, respectively. The specificity (100% versus 89%) and positive predictive value of the test (100% versus 8%) fell markedly from the ANA-negative to the ANA-positive group. As a conclusion, this study verified our suspicion about the effect of autoantibodies on rose bengal test results to the diagnosis of human brucellosis. However, to have definite decisions, extensive studies with larger populations are needed.     

HIV抗体诊断试剂特异性样品库的建立

目的 建立评价HIV抗体诊断试剂特异性的样品库。方法 从不同地区收集献血者样品990份，采用HIV抗体检测试剂和HIV抗原抗体联合检测试剂进行筛选，对结果不一致样品采用HIV抗体确认试剂和HIV核酸检测试剂进行检测。结果 筛选出985份样品组成样品库，各试剂检测样品库的特异性为97．77％～99．90％，其“δ”为-1．774～-4.690，且两者具有较好的相关性。结论 该样品库样品能够反映试剂特异性的差异，可用于对试剂特异性的分析。     

布氏菌特异性转移因子临床治疗观察

本文报道布氏菌特异性转移因子(PSBr-TF)对布鲁氏菌病奶牛的治疗及辅助治疗结果。实验表明,PSBr-TF无论单独用以治疗或与其他药物合用均可收到很好的效果。布氏菌病奶牛经PSBr-TF治疗后,临床症状基本消失,食欲恢复正常、产奶量增加,主要血清学和乳环反应阳性率下降,细菌学检查阴性,并缓减或治愈了一些并发症。临床观察治愈率为13.5％,总有效率为72.7％若与链霉素合用,可显著提高疗效,总有效率达100％。它比链霉素使用方便注射剂量和次数少,且材料来源广,生产成本低,无毒无副作用。治疗布氏菌病优于链霉素。     

单核苷酸多态性敏感分子开关在基因组单核苷酸多态性检测中的特异性分析

目的 探讨硫化修饰的碱基特异性引物与高保真DNA聚合酶所构成的对单核苷酸多态性敏感的分子开关系统在基因组单核苷酸多态性检测中的特异性。方法以人类基因组DNA为模板，采用3’未端配对及不配对的3’末端硫化修饰引物，进行不同保真度DNA聚合酶介导的引物延伸反应。结果Taq酶介导的碱基特异引物延伸反应扩增产物出现非特异性带，而单核苷酸多态性敏感分子开关介导的引物延伸反应未出现非特异性带。结论单核苷酸多态性敏感分子开关是一种特异性强，可靠性高的可用于基因组单核苷酸多态性分析的新方法，可在单碱基水平对遗传病相关基因进行特异性检测。     

Role of 16-multidetector computed tomography in the assessment of coronary artery stenoses: A prospective study of consecutive patients

BACKGROUND: Recent studies have demonstrated a high sensitivity (S) of 16-multidetector computed tomography (16-MDCT) for the detection of significant coronary artery stenoses. Whether these results are applicable to clinical practice is unclear. Therefore, the aim of the present study was to compare 16-MDCT angiography with conventional coronary angiography (CCA) for the detection of significant coronary artery stenoses in a consecutive series of patients. METHOD: A total of 93 consecutive patients (mean [+/- SD] age 59+/-9 years), in whom CCA was performed for stable angina pectoris, underwent 16-MDCT angiography (16x0.75 mm, table feed 6.5 mm/s, rotation time 0.42 s; Sensation 16, Siemens Medical Solutions, Germany) the day before performing CCA. Patients with diabetes mellitus, serum creatinine level higher than 132.6 mumol/L and/or acute coronary syndromes were excluded. Two observers blinded to CCA results evaluated MDCT angiograms according to standard criteria. Segment-based (13 segments per patient) and patient-based (at least one stenosis greater than 50% lumen diameter reduction) analyses were performed. RESULTS: A total of 1209 segments were analyzed. Of these segments, 173 (14%) were excluded due to poor image quality or massive calcification. In 86 segments, CCA revealed significant coronary artery stenosis (greater than 50% diameter reduction). However, 16-MDCT detected only 47 of these, resulting in a S of 55% and a specificity (SP) of 97% (positive predictive value 64%; negative predictive value 96%). On a patient-based analysis, the S increased to 89%, whereas the SP still remained high (87%). CONCLUSION: In this relatively large consecutive cohort, S for the detection of significant coronary artery stenoses was moderate on a segment-based analysis but increased on a patient-based analysis using 16-MDCT. In contrast, SP was high in both analyses, supporting the use of 16-MDCT for the exclusion of significant coronary artery stenoses. Further improvement of spatial and temporal resolution in MDCT technology may lead to a lower exclusion rate and higher S.     

中危人群双源CT冠脉显像检测冠状动脉狭窄的可靠性

目的探讨冠状动脉(冠脉)双源CT(DSCT)评价冠状动脉性心脏病(冠心病)中危人群冠脉狭窄的准确性。方法选择2006-07-2009-05至我院行冠状动脉造影(冠脉造影)的冠心病中危患者67例,男42例,女25例,分别给予双源CT和冠脉造影检查(不予心率控制)。双盲法对图像资料结果进行比较分析。结果66例获得了清晰的图像。在至少有一处狭窄>50%的患者16例中,15例由双源CT准确发现,敏感性93.8%。在无狭窄>50%的患者50例中,45例由双源CT准确排除,特异性90.0%。双源CT诊断冠脉狭窄≥50%的敏感性为94.3%,特异性98.8%,阳性预测值75.0%,阴性预测值99.8%;诊断冠脉狭窄≥75%的敏感性为94.1%,特异性99.4%,阳性预测值76.2%,阴性预测值99.9%。kappa一致性分析发现双源CT与冠脉造影的结果有较好的一致性(κ=0.79,P<0.01)。结论双源CT判断冠心病中危人群冠脉狭窄情况的敏感性及特异性均较高,可作为此人群筛查的安全、可靠方法。     

用飞行质谱技术筛选肝棘球蚴病患者血清蛋白质组学标记物

目的 筛选肝棘球蚴病患者血清蛋白质组学标记物,建立血清蛋白质指纹图诊断模型,评价其应用价值.方法 肝棘球蚴病患者68例,对照组73例(其他肝病患者33例,健康人40例),将全部样品分为训练组(37例)和测试组(67例).用弱阳离子交换蛋白芯片结合表面增强激光解析电离飞行时间质谱(SELDI-TOF-MS)技术检测肝棘球蚴病患者和对照者的血清蛋白质谱.分别比较训练组中37例肝棘球蚴患者和37例对照者、5例肝囊型棘球蚴病(HCE)患者和5例肝泡球蚴病(HAE)患者、8例肝棘球蚴病患者手术前后两组血清蛋白质峰的差异.利用ZJU-PDAS软件进行数据处理,通过支持向量机(SVM)运算建立蛋白质指纹图诊断模型,并用测试组标本采用盲法对模型的灵敏度和特异度进行验证.结果 肝棘球蚴病组和对照组共筛选出9个差异蛋白峰,其中相对分子质量为1044、1047、1073、1075、1338、6453、6649、8714 m/z的8个蛋白质峰在病例组中下调,相对分子质量为5651 m/z的蛋白峰在病例组中上调(P<0.05),盲法验证表明所建模型对肝棘球蚴病诊断的灵敏度为77.4%(24/31),特异度为66.7%(24/36);阳性预测值为66.7%(24/36),阴性预测值为77.4%(24/31).HCE和HAE患者之间筛选出2个差异表达蛋白峰,质荷比分别为8716和2751 m/z(P<0.05);8例肝棘球蚴病患者手术前后两组共筛选出6个差异表达蛋白质峰,相对分子质量分别为1297、1505、1525、1534、5921,5941 m/z(P<0.05).结论 SELDI-TOF-MS技术结合生物信息学方法能筛选出肝棘球蚴病患者血清蛋白质组学标记物,对肝棘球蚴病诊断及预后判断具有潜在的应用价值.     

艾滋病患者体表针吸活检病理诊断精确性研究

目的本研究分析了艾滋病患者体表淋巴结、皮肤黏膜肿物针吸细胞学病理的精确性、敏感性、特异性、阴性/阳性预测值,同时分析艾滋病针吸细胞学病理的常见疾病谱。方法对85例艾滋病针吸细胞学病理标本进行分析,将病理结果分为阳性、阴性、可疑阳性和诊断不满意,并和临床病原学检查、临床疗效和随访结果进行对比。结果 85例艾滋病针吸细胞学病理结果显示精确性、敏感性、特异性、阳性和阴性预测值分别为87.1%[95%CI(0.78,0.94)]、85.7%[95%CI(0.77,0.94)]、90.9%[95%CI(0.79,1.00)]、96.4%[95%CI(0.92,1.00)]和69.0%[95%CI(0.52,0.86)];艾滋病患者体表淋巴结、皮肤黏膜肿物针吸细胞学病理结果以淋巴结结核为主,其次为鸟分枝杆菌感染、马尔尼菲青霉菌感染、隐球菌感染,体表弥漫大B型淋巴瘤和伯基特淋巴瘤也可通过针吸细胞学病理诊断。结论本研究发现艾滋病针吸细胞学活检病理精确性、特异性、敏感性和阳性预测值高,对艾滋病机会性感染和肿瘤的诊断帮助较大;但阴性预测值低,要警惕假阴性结果的出现。     

变性高效液相色谱分析技术对乳腺癌易感基因突变位点检测的敏感性和特异性

目的探讨变性高效液相色谱分析技术对乳腺癌易感基因突变位点检测的敏感性和特异性。方法收集202例诊断为原发性乳腺癌女性患者,同时采用PCR/DNA测序法和变性高效液相色谱分析技术检测对所有患者进行BRCA1基因突变的筛查,以PCR/DNA测序法作为金标准,评估变性高效液相色谱分析技术的敏感性和特异性。结果本研究202例乳腺癌标本中,PCR/DNA测序法发现BRCA1基因突变例数为76例,变性高效液相色谱分析技术结果也为阳性例数为73例,敏感性为96.1%;PCR/DNA检测结果为阴性的总共126例标本,采用变性高效液相色谱分析技术,结果也为阴性的总标本例数为120例,特异性为95.2%。两种检测方法敏感性(100%vs 96.1%,P=0.265)和特异性(100%vs 95.2%,P=0.226)无统计学差别。结论与传统检测方法相比采用变性高效液相色谱分析技术检测乳腺癌易感基因BRCA1具有较高的敏感性和特异性,值得推广。