Infrared spectroscopy: A new diagnostic tool in Alzheimer disease

Biological markers play an evolving role in the diagnosis of Alzheimer disease (AD). We compare conventional measurements of cerebrospinal fluid (CSF) tau and β-amyloid_1–42 proteins to a novel approach – Fourier transformed infrared (FT-IR) spectroscopy – a simple technique derived from chemical and physical sciences that characterizes intramolecular bonds. For automatic diagnostic analysis, we developed an artificial neural network (ANN). We examined 71 patients with a clinical diagnosis of AD and 66 controls. β-Amyloid_1–42 was decreased (sensitivity 80% and specificity 78%); tau was elevated (sensitivity 76% and specificity 88%) in CSF of AD patients. The combined tau/β-amyloid_1–42 quotient was able to distinguish healthy from diseased subjects with 99% sensitivity and 86% specificity. The ANN could separate FT-IR spectroscopy data with 88.5% sensitivity and 80% specificity. FT-IR spectroscopy proved to be cost-effective and simple to perform. Diagnostic sensitivity and specificity is in the range of CSF tau and β-amyloid_1–42 protein analysis. Larger sample numbers for ANN training and validation could increase diagnostic accuracy and thus prove to be a useful screening tool.     

不同b值条件下心脏体素内不相干运动成像相关参数的一致性

目的观察不同b值条件下心脏体素内不相干运动(IVIM)成像相关参数的一致性。方法对30名健康志愿者行左心室中间部IVIM扫描,以双指数模型获取IVIM参数值慢速表观弥散系数(ADCslow)、快速ADC(ADCfast)及灌注分数f。比较9个b值(0、20、50、80、100、120、200、300、500 s/mm^2)与7个b值(0、20、80、100、200、300、500 s/mm^2)条件下所测参数值的差异,采用组内相关系数(ICC)分析2名医师测量参数结果的一致性,以Bland-Altman检验分析不同b值条件下所测参数的一致性。结果9个与7个b值条件下ADCslow、ADCfast及f差异均无统计学意义(P均>0.05),且2名医师测量IVIM参数的组内及组间一致性均较好(ICC均≥0.66,P均<0.05)。Bland-Altman图显示,9个与7个b值时ADCslow的平均偏差为-0.07×10-3 mm^2/s,一致性界限(-1.87,1.73);ADCfast的平均偏差1.57×10-3 mm^2/s,一致性界限(-72.64,75.77);f的平均偏差1.17%,一致性界限(-13.45,15.79)。结论9个与7个b值条件下心脏IVIM成像各参数值的一致性较好。     

Influence of age and human papillomavirus-infection on reliability of cervical cytopathology

The aim of the present study was to evaluate the effect of age and human papillomavirus (HPV) infection associated cellular changes on the predictive value of cervical cytology. In a group of 671 women with Papanicolaou smears suggesting low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) or invasive cervical cancer, cervical cytology was correlated with the histological finding. Predictive values were calculated and related to severity of the lesion, age and HPV associated changes. The predictive values of Papanicolaou (cervical) smears suggesting LSIL, HSIL and invasive carcinoma were 40%, 86%, and 78%, respectively. A poor predictive value of smears suggesting LSIL was found among older women. HPV associated changes were diagnosed in 80% of women 25 years of age, 66% in the age group 26 to 35 years, 51% in the age group 36 to 45 years and 38% in women aged 46 years (P = 0.03). The presence of HPV associated cellular changes led to a significantly higher number of overdiagnoses (9% with HPV infection compared to 4% without HPV infection) and HPV negative cases were more frequently associated with underdiagnosis (15% without HPV infection compared to 8% with HPV infection,P = 0.0011). This result remained significant after adjustment for age (P = 0.004). Cellular changes associated with HPV infection most frequently occurred in young women. HPV infection should therefore be acknowledged as source of overdiagnosis in the cytological evaluation of SIL especially in woung women.Supported by the Research Grant of the Mayor of Vienna (no. 1045 [to Dr. Kainz])     

Evaluation of delta-aminolaevulinic acid excretion in random urine samples of children

Urinary delta-aminolaevulinic acid (-ALA) excretion was evaluated in random urine samples of 191 healthy children, aged 2–14 years, with blood lead levels <0.8 mol/l (mean ± SD: 0.34±0.13), erythrocyte zinc-protoporphyrin <70 mol/mol haem (mean ± SD: 50.4±8.0) and blood haemoglobin >6.8 mmol/l (mean ± SD: 8.2±0.5). It was found that uncorrected -ALA concentration and -ALA/creatinine ratio are age-dependent, whereas the ratio of -ALA/logarithm of creatinine concentration (mean ± SD: 55.3±13.5 mol/log mmol) is independent of age and sex. The authors recommend the use of this parameter for the assessment of -ALA excretion in random urine samples in children     

Retrospective prediction of birth weight by growth velocity curves during neonatal period

In this prospective study, birth weight of 304 babies born at Kamla Nehru Hospital Pune during study period was recorded. From these 304 babies, babies with birth weight above 2000 grams were selected (260 babies) to prepare growth velocity curves. Daily weight of these 260 babies was recorded for 30 days. The mean birth weight of study population was 2742.5 grams. Among the daily weight recorded babies, all the babies lost weight ranging from 92 to 218 grams (mean 121 grams) after birth. The weight loss continued upto 5 days. Days required to gain weight equal to birth weight ranged from 5 to 13 days. Total weight gain observed in 30 days was 734.7 grams. Predictive value of these curves was tested in 49 infants. Deviation upto 50 grams of predicted birth weight from actual birth weight was observed in 90% of babies on day-2, 79% on day-4, 65% on day-8 and 39% on day-30.     

国人（195例）重心动摇计检查正常值的测定

目的：为测得正常中国人重心动摇检查各项正常值。方法：１９５例无晕与平衡障碍的人行重心动摇检查，得到各项测试值，结果：与日本学会标准比较，睁眼与闭眼外周面积值各年龄组无益氏于日本学会标准，其余各项数值相仿。结论；国人重心动摇应参照中国人的正常值。     

危重症评分量表对急诊病人转入ICU及死亡的预测能力研究

目的:探讨危重症评分量表对急诊病人转入重症监护室(ICU)及死亡的预测能力。方法:采用方便抽样法选取2019年1月—2019年12月在我院急诊科就诊的250例病人作为研究对象,最终纳入228例病人,按转入科室分为ICU组(68例)及普通病房组(160例)。应用改良早期预警评分(MEWS)量表和急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评估病人病情,记录病人ICU转入率及死亡率,并应用受试者工作特征曲线(ROC)分析MEWS量表、APACHEⅡ量表在急诊病人ICU转入率及死亡率中的预测价值。结果:与普通病房组相比,ICU组MEWS评分、APACHEⅡ评分更高(P<0.001)。死亡组MEWS评分、APACHEⅡ评分高于非死亡组(P<0.001)。经ROC曲线分析可知,MEWS评分、APACHEⅡ评分诊断急诊病人转入ICU的最佳截断值分别为4分和20分,两者联合诊断急诊病人转入ICU的敏感度及特异度明显高于MEWS评分、APACHEⅡ评分单项诊断。MEWS评分、APACHEⅡ评分诊断急诊病人死亡最佳截断值分别为6分和25分,两者联合诊断急诊病人死亡的敏感度及特异度高于...     

干扰素调节因子 5、粒细胞 -巨噬细胞集落刺激因子在细菌性肺炎病儿血清中的表达及预后价值

目的探讨干扰素调节因子 5(interferon regulatory factor 5,IRF5)、粒细胞 -巨噬细胞集落刺激因子( granulocyte-macrophage colony-stimulating factor,GM-CSF)在细菌性肺炎病儿血清中的表达变化及疾病预后价值。方法选取 2019年 4月至 2021年 5月中国人民解放军联勤保障部队第九二八医院收治的细菌感染性肺炎病儿 96例作为细菌组,同期非细菌感染性肺炎病儿 88例作为非细菌组,另外选取健康体检儿童 96例为对照组,收集检测三组病儿基本临床资料。检测血清中 IRF5、GM-CSF及其组间差异;采用 Pearson法分析细菌性肺炎病儿血清 IRF5、GM-CSF水平与病情指标的相关性;应用受试者操作特征曲线(ROC曲线)分析 IRF5、GM-CSF及二者联合预测细菌性肺炎预后的价值。结果细菌组血清 IRF5水平［(38.85±13.86)ng/L］显著高于非细菌组［( 11.15±4.37)ng/L］和对照组［( 10.76±1.55)ng/L］,且重症组高于轻症组( P<0.05);细菌组血清 GM-CSF水平［(54.73±16.56)ng/L］显著低于非细菌组［(246.73±28.94)ng/L］和对照组［(250.64±55.67)ng/L］,且重症组低于轻症组( P<0.05)。重症组气促、吐沫、三凹征、肺部明显湿啰音比例、 C反应蛋白( C-reactive protein,CRP)、白细胞水平显著高于轻症组、非细菌组(P<0.05)轻症组、非细菌组 CRP水平显著高于对照组( P<0.05),非细菌组 CRP水平显著高于对照组( P<0.05)。血清 IRF5水平与 CRP、,白细胞、临床肺部感染评分( clinical pulmonary infection score,CPIS)均呈正相关( r=0.34、0.36、0.41,P<0.05)血清 GM-CSF水平与 CRP、白细胞、 CPIS均呈负相关( r=-0.40、-0.32、-0.45,P<0.05)。预后不良组血清 IRF5水平高于预后良好,组,血清 GM-CSF水平低于预后良好组( P<0.05)。 ROC曲线显示, IRF5、GM-CSF对预后预测的 AUC分别为 0.90、0.87,二者联合对预后预测的 AUC为 0.96,明显高于二者单独诊断,(Z联合 vs.IRF5=2.86,P=0.004;Z联合 vs.GM-CSF =2.24,P=0.025),其灵敏度、特异度分别为 90.32%、90.77%。结论细菌性肺炎病儿血清 IRF5水平升高, GM-CSF水平降低,二者在评估病情进展及疾病预后预测方面具有较高的价值。     

第三代双源CT在心律不齐冠脉CTA检查中的应用价值

目的 探索第三代双源CT在心律不齐患者冠状动脉CT血管造影(CT angiography,CTA)扫描过程中的应用.方法 选择本院收治的心律不齐患者96例,随机分为对照组和观察组进行CTA扫描,各48例.对照组给予第一代双源CT上行常规CT技术进行检查,观察组给予第三代双源CT上行低管电压、低剂量碘造影剂的双低技术进行...     

Atlas 9000、Orbscan和Pentacam测量近视角膜非球面系数（Q值）的差异和一致性

目的　评价Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ三种方法测量近视患者角膜非球面系数（Ｑ值）的差异和一致性。方法　横断面比较性研究,随机选取在广西视光中心就诊的成年近视患者４９例（９８眼）,分别应用Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ测量患者的角膜Ｑ值。采用随机区组设计资料的方差分析（Ｔｗｏ-ｗａｙＡＮＯＶＡ）比较不同仪器测量结果的差异,采用Ｐｅａｒｓｏｎ相关系数分析不同仪器测量结果的相关性,采用Ｂｌａｎｄ-Ａｌｔｍａｎ分析评价不同方法测量结果的一致性。结果　Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ测得的角膜Ｑ值分别为－０．３４２±０．１３５、－０．３０２±０．１８２和－０．３０５±０．１２０,三种方法测得角膜Ｑ值差异有统计学意义（Ｆ＝５．４６５,Ｐ＝０．００５）,两两比较表明Ａｔｌａｓ９０００与Ｏｒｂｓｃａｎ、Ｐｅｎｔａｃａｍ的检测结果比较差异均有统计学意义（均为Ｐ＜０．０５）,测得负值更大,但Ｏｒｂｓｃａｎ与Ｐｅｎｔａｃａｍ检测结果间比较差异无统计学意义（Ｐ＞０．０５）。Ｐｅａｒｓｏｎ相关分析显示,Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ与Ｐｅｎｔａｃａｍ测得的角膜Ｑ值之间均有正相关性（均为Ｐ＜０．００１）。Ｂｌａｎｄ-Ａｌｔｍａｎ一致性分析表明Ａｔｌａｓ９０００与Ｐｅｎｔａｃａｍ一致性好。结论　Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ测量近视患者角膜Ｑ值存在一定差异,但Ａｔｌａｓ９０００与Ｐｅｎｔａｃａｍ的一致性较好,两者可相互参考。