超声造影在肾脏肿瘤诊断及鉴别诊断中的研究进展

超声造影可实时显示新生肿瘤的微血流灌注情况,在鉴别诊断肾脏肿瘤的良恶性方面有较高的价值,目前已较广泛地应用于肾脏肿瘤的临床诊断。超声造影可通过显示不同病理类型肾脏肿瘤间血管特质的差异,对肾脏肿瘤的病理类型进行甄别,为指导临床精准治疗提供重要的诊断依据。本文就近年来超声造影在诊断及鉴别诊断肾脏肿瘤中的研究进展进行综述。     

肝内胆管细胞癌的影像学诊断进展

近年来,肝内胆管细胞癌的发病率有持续上升趋势,早期诊断和准确分期诊断是临床关注重点。随着影像学技术的进步,对该病的认识及诊断水平有了明显提高,本文就该病的常见影像学表现和影像诊断进展进行综述。     

超声诊断骨折进展

超声可通过多方位扫查观察骨折部位、大小、断端移位及周围组织水肿或血肿，已用于诊断肋骨、掌骨、软骨、鼻骨等部位骨折，为临床诊断骨折、尤其隐匿性骨折提供重要依据。本文对超声成像技术在骨折诊断中的应用和发展进行综述。     

颅内动脉狭窄的诊断与治疗进展

<正>脑动脉粥样硬化性狭窄是缺血性脑卒中的重要发病机制,因为人种的不同,动脉粥样硬化的分布也有很大的区别,白种人多表现为颅外段的动脉病变,而颅内动脉粥样硬化性狭窄则是亚洲患者脑卒中的重要原因,占患者病因构成的33%～51%。在我国,缺血性脑血管病的颈动脉系统颅内段血管狭窄     

Development of a questionnaire for the diagnosis of Qi stagnation

The objective of this study was to develop a questionnaire for the diagnosis of Qi stagnation. At first, we made the preliminary version of the questionnaire from 30 symptoms most frequently mentioned about Qi stagnation in classic books of Oriental Medicine. Two hundred and seven participants completed the preliminary version of the questionnaire rating the severity of 30 symptoms. Those participants were assessed for Qi stagnation by 2 physicians. Logistic regression analysis was performed between the physicians' assessment of Qi stagnation and the severity of symptoms in the preliminary questionnaire. The final version of the questionnaire was developed with 23 symptoms that had significant odds ratios. The Cronbach's α coefficient was 0.83. The area under the curve was 0.90 and cut-off value for diagnosis of Qi stagnation was 28.5 in receiver operating characteristic (ROC) analysis. Sensitivity and specificity were 0.83 and 0.80, respectively. The Spearman's correlation coefficient was 0.72 in the test-retest. This questionnaire would enable standardization and objective verification of the diagnosis of Qi stagnation.     

Development of chip-compatible sample preparation for diagnosis of infectious diseases

Diagnosis of infectious diseases in primary care is predominantly based on medical history and physical examination, as conventional laboratory investigations are often associated with delays that are unacceptable in medical practice. Point-of-care testing, and especially lab-on-a-chip (LoC) systems, are expected to result in a considerable reduction in associated healthcare costs and lead to fast, but appropriate and effective, personalized therapy. Although appropriate sample preparation is essential for final detection, most microfluidic-based approaches start from samples prepared by conventional laboratory procedures, therefore continuing to restrict the use of these systems to a laboratory setting. The lack of integrated sample preparation, especially for sample volumes in the milliliter range, is a major drawback of existing LoC systems. LoC systems that start with real samples and perform a full protocol from sample to result are still rare. In this article, the most recent advances in on-chip sample preparation are reviewed for microfluidic-based diagnosis of infectious diseases.     

Development of a multiplexed urine assay for prostate cancer diagnosis

BACKGROUND: Several studies have demonstrated the value of DNA methylation in urine-based assays for prostate cancer diagnosis. However, a multicenter validation with a clinical prototype has not been published. METHODS: We developed a multiplexed, quantitative methylation-specific polymerase chain reaction (MSP) assay consisting of 3 methylation markers, GSTP1, RARB, and APC, and an endogenous control, ACTB, in a closed-tube, homogeneous assay format. We tested this format with urine samples collected after digital rectal examination from 234 patients with prostate-specific antigen (PSA) concentrations > or =2.5 microg/L in 2 independent patient cohorts from 9 clinical sites. RESULTS: In the first cohort of 121 patients, we demonstrated 55% sensitivity and 80% specificity, with area under the curve (AUC) 0.69. In the second independent cohort of 113 patients, we found a comparable sensitivity of 53% and specificity of 76% (AUC 0.65). In the first cohort, as well as in a combined cohort, the MSP assay in conjunction with total PSA, digital rectal examination status, and age improved the AUC without MSP, although the difference was not statistically significant. Importantly, the GSTP1 cycle threshold value demonstrated a good correlation (R = 0.84) with the number of cores found to contain prostate cancer or premalignant lesions on biopsy. Moreover, samples that exhibited methylation for either GSTP1 or RARB typically contained higher tumor volumes at prostatectomy than those samples that did not exhibit methylation. CONCLUSIONS: These data confirm and extend previously reported studies and demonstrate the performance of a clinical prototype assay that should aid urologists in identifying men who should undergo biopsy.     

我国产前诊断技术发展与质量控制

产前诊断是针对母体所怀胎儿是否异常开展的技术,从母体血清学筛查,到细胞遗传学的染色体核型分析、基因的分子诊断等,是目前防止与减少出生缺陷的主要手段.借鉴欧美发达国家的经验,我国较大规模的产前诊断工作已开展,主要为唐氏综合征血清学筛查,以及染色体病的产前诊断,常见遗传病的基因诊断也已开展,但各地区发展不平衡.作为涉及国家、民族可持续发展的群体性疾病预防工程,尚需建立或完善适合我国国情的产前诊断体系与质量管理规范.     

糖尿病肾病诊断名称的变迁

糖尿病肾病是常见的继发性肾脏病之一,随着病情的进展可以导致慢性肾功能衰竭甚至尿毒症。几十年来糖尿病肾病的诊断名称几经更新,从Kimmelstiel Wilson综合征到糖尿病肾病,再到较近的糖尿病肾脏疾病,虽然涵盖的意义有所重叠,但对于疾病的描述和定义更加精准、完善,也更适用于临床实践。诊断名称的变化也是对疾病本身的探索过程,本文就糖尿病肾病诊断名称的变迁做一综述。     

影像学的发展与颈椎退行性变的诊断和治疗

随着近几年医学影像学的快速发展如X射线摄影数字化、计算机X射线摄影(DR)、直接数字化X射线摄影(CR),使原有的X射线颈椎摄片显示有了大大的改善;CT技术发展更是让人惊叹,螺旋CT探测器由原来的2层发展到目前640层,双源CT的出现除提高扫描速度,也使三维重建达到"类似解剖化"显示;磁共振技术由原来的低场发展至目前高场与超高场,提供的信息量大大增加.在多种影像学快速发展的今天,影像学所提供的信息甚至已经超过临床症状表示与临床体征发生.颈椎退行性变(颈椎退变)中影像学表现反映颈椎退变与相关病损改变,且影像学表现与颈椎病的临床症状、体征变化并不完全一致;有时颈椎退变影像学表现非常典型,却没有临床症状与体征;有时颈椎退变影像学表现很轻或几乎没有影像学表现明显表现,而临床症状与体征典型.了解颈椎退变影像学表现与诊断颈椎病的关系对正确把握颈椎病治疗具有重要意义.     

干血斑标本珠蛋白生成障碍性贫血基因检测方法的建立

目的建立并优化干血斑标本基因组DNA提取方法和流程,以适用于临床进行珠蛋白生成障碍性贫血(又称地中海贫血,以下简称地贫)基因诊断,并对干血斑打孔标本间可能的交叉污染和保存的稳定性进行分析。方法收集150份血液标本制备干血斑后,采用打孔仪打孔,用洗脱裂解液对血斑进行洗脱,并对洗脱方法进行优化,采用磁珠法提取血斑DNA,再进行地贫基因检测,判断干血斑和全血的地贫基因检测结果是否相符。干血斑采用2种地贫基因检测方法进行检测,以验证其是否适用于多种方法。地贫阳性标本间打空白孔,对空白孔进行地贫基因检测确定打孔是否存在交叉污染。将干血斑常温干燥保存6、9个月后进行地贫基因检测,以判断其稳定性。结果采用5个3mm直径的干血斑在55℃振荡洗脱1h,可以获得DNA浓度10~20ng/μL(50μL DNA溶解液),DNA质量好。干血斑和全血的地贫基因检测结果完全一致,干血斑的2种地贫基因检测方法的结果也完全一致。打孔仪连续对干血斑打孔,地贫基因未检测出交叉污染。干血斑标本存放6、9个月后依然能够稳定地进行地贫基因检测。结论干血斑标本可以准确、方便、稳定地进行地贫基因检测,是地贫基因检测标本转诊的理想方式。     

Development of a real-time tactile sensing system for brain tumor diagnosis

Purpose  

Tactile sensing techniques may distinguish tumor from healthy tissue and have potential for intraoperative brain tumor diagnosis. The aim of this study is to develop a biocompatible real-time sensing system to measure tactile information such as softness and smoothness, and its application to brain tumor diagnosis.     

Development of written case studies as simulations of diagnosis in nursing.

Written case studies, as simulations of diagnosis in nursing, are valuable tools for research, education, and practice. This article presents guidelines and methods for systematic development of valid and reliable case studies. Examples of purposes, objectives, and methods are given. A content validity form and directions also are provided.     

Development and evaluation of multiplex PCR in rapid diagnosis of abdominal tuberculosis

The clinical features of abdominal tuberculosis (TB) are non-specific and establishing a diagnosis remains a challenge. A delay in diagnosis is likely to increase the morbidity in these patients. We developed a multiplex polymerase chain reaction (PCR) using 16SrRNA, IS6110, and devR, and evaluated it in comparison with other conventional tests in clinical suspects of abdominal TB. A total of 183 patients with clinical suspicion of abdominal TB (96 patients with intestinal TB and 87 with peritoneal TB) were enrolled for the study. Endoscopic or intraoperative biopsies were collected from patients suspected of intestinal TB and ascitic fluid was collected from patients with a suspicion of peritoneal TB. Of the intestinal tuberculosis group, there were 40 confirmed cases and 56 controls, while of the peritoneal tuberculosis group there were 37 confirmed cases and 50 controls. Multiplex PCR showed a high sensitivity and specificity in both the intestinal TB and peritoneal TB groups. When combined with histopathology, multiplex PCR could detect 97.5% of all the cases in the intestinal tuberculosis group, while in combination adenosine deaminase levels (ADA) in cases of peritoneal tuberculosis it increased the specificity of diagnosis of peritoneal tuberculosis to 95%. In combination with histopathology in suspected intestinal TB cases, and ADA testing in suspected peritoneal TB cases, it can be used as a highly sensitive, specific, and rapid diagnostic tool with the ability to supplement the limitations of other diagnostic modalities.     

Development of a PCR-based method for diagnosis of Leishmania in blood samples

Visceral Leishmaniasis (VL) cases reported in Mediterranean countries and in Northern Europe are becoming increasingly frequent. The past few years several studies have shown Polymerase Chain Reaction to be more effective than the classical methods for the diagnosis of VL in clinical samples. The purpose of this study was the development of a simple, specific and sensitive PCR-based assay for the detection of Leishmania in blood samples. A specific pair of oligonucleotides was designed using conserved sequences of the ssu-rRNA Leishmania infantum gene. Of the 53 blood samples of patients suspected for leishmaniasis that were processed with the newly designed oligonucleotides, 13 were successfully diagnosed positive. The results were confirmed with sequencing and restriction fragment length polymorphism. The lower detection limit of the reported assay was 10 parasites per ml in all seeded samples tested and considered highly satisfactory for diagnosis of Leishmaniasis in blood samples.