BACKGROUND & AIMS: :There is a substantial need for a diagnostic tool to aid in the early diagnosis of heart failure and in the recognition of those at risk for its development, as well as in guidance of therapy. Testing for amino-terminal pro-brain natriuretic peptide (NT-proBNP) has been recognized to have utility in the diagnosis, prognosis and management of heart failure. In addition, numerous other applications for NT-proBNP testing are now recognized, such as evaluation of patients with heart disease in the absence of heart failure, as well as the diagnostic and prognostic evaluation of patients with acute coronary syndromes or pulmonary thromboembolism.

背景与目标： ：非常需要一种诊断工具来辅助心力衰竭的早期诊断，并认识到可能发展为心力衰竭的人，以及指导治疗。氨基末端脑钠肽（NT-proBNP）的检测已被认为可用于心力衰竭的诊断，预后和管理。此外，现在还认可了NT-proBNP测试的许多其他应用，例如在没有心力衰竭的情况下评估心脏病患者，以及对急性冠状动脉综合征或肺血栓栓塞患者的诊断和预后评估。

BACKGROUND & AIMS: OBJECTIVE:To compare the relative sensitivity of direct microscopy, fungal culture and nail plate biopsy in the diagnosis of onychomycosis. DESIGN:Cross-sectional study. PLACE AND DURATION OF STUDY:The Skin Department, Military Hospital, Rawalpindi from February 1998 to February 1999. PATIENTS AND METHODS:A total of 50 patients who were suffering from different clinical variants of onychomycosis, irrespective of their age, gender, with or without simultaneous presence of systemic diseases, were subjected to laboratory investigations including direct microscopy with 20% potassium hydroxide (KOH) for fungal hyphae, fungal cultures and nail plate biopsies. These patients were later categorized into two groups based upon the results of nail plate biopsies. RESULTS:Of 50 patients, 15 (30%) were positive for fungal elements in direct microscopy, 8 (16%) were positive for fungal culture and 16 (32%) revealed positive results in nail plate biopsies. Amongst nail plate biopsy positive cases, 10 (63%) were positive for direct microscopy and 6 (37.5%) were positive for fungal cultures. In biopsy negative cases, positive results for direct microscopy were seen in 5 (14.7%) patients and positive fungal culture was found in 2 (5.88%) patients. CONCLUSION:The clinical impression of onychomycosis is not true in all the cases. Nail scraping for direct microscopy with 20% KOH should be the first line screening test for all patients which should then be supplemented with fungal culture and/ or nail plate biopsy.

背景与目标： 目的：比较直接显微镜，真菌培养和钉板活检在甲癣诊断中的相对敏感性。
设计：横断面研究。
研究的地点和时间：1998年2月至1999年2月，拉瓦尔品第军事医院皮肤科。
患者和方法：总共50例患有灰指甲病的不同临床变体的患者，不论年龄，性别，是否同时存在全身性疾病，均接受了实验室检查，包括直接显微镜检查和20％氢氧化钾（KOH） ）用于真菌菌丝，真菌培养物和指甲板活检。根据指甲板活检的结果，这些患者随后被分为两组。
结果：在50例患者中，直接显微镜下的真菌成分阳性15例（30％），真菌培养阳性8例（16％），而指甲板活检阳性16例（32％）。在指甲板活检阳性病例中，直接显微镜检查阳性10例（63％），真菌培养阳性6例（37.5％）。在活检阴性的病例中，直接显微镜检查的阳性结果为5名（14.7％），真菌培养阳性的为2名（5.88％）。
结论：并非所有情况下甲癣的临床印象都是真实的。对于所有患者，一线筛查测试应为使用20％KOH的直接镜检刮指甲，然后再进行真菌培养和/或指甲板活检。

BACKGROUND & AIMS: :Molecular biology techniques are applied for the diagnosis of meningoencephalitis due to herpesviruses, enteroviruses or polyomaviruses, for the diagnosis of human cytomegalovirus, human parvovirus B19, varicella-zoster virus and rubella virus infections occurring during pregnancy, for the diagnosis and the management of retrovirus infections (HIV and HTLV) and of hepatitis (HBV and HCV), for papillomavirus typing and to detect a link between virus and clinical manifestations (cardiomyopathy or insulinodependent diabetes with coxsackievirus B: Kaposi's sarcoma with HHV 8) or to investigate an environmental contamination with viruses. These new molecular markers which are both qualitative and quantitative represent an important advance in the field of viral diagnosis research, in the monitoring of viral load during the course of infection, in the therapy control of viral disease and in the epidemiology of virus spread. Standardization and automatization are obtained using available commercial reagents and kits.

背景与目标： ：分子生物学技术被用于诊断由疱疹病毒，肠病毒或多瘤病毒引起的脑膜脑炎，用于诊断人巨细胞病毒，人细小病毒B19，水痘-带状疱疹病毒和风疹病毒在怀孕期间发生的感染，用于诊断和管理逆转录病毒感染（HIV和HTLV）和肝炎（H​​BV和HCV），用于乳头瘤病毒分型并检测病毒与临床表现之间的联系（心肌病或胰岛素依赖型糖尿病与柯萨奇病毒B：卡波西氏肉瘤伴HHV 8）或调查环境污染病毒。这些新的定性和定量分子标记代表了病毒诊断研究领域，感染过程中病毒载量的监测，病毒疾病的治疗控制和病毒传播的流行病学的重要进展。使用可用的市售试剂和试剂盒可获得标准化和自动化。

BACKGROUND & AIMS: OBJECTIVES:This prospective study was designed to assess the sensitivity and specificity of Doppler ultrasound parameters in the diagnosis of cirrhosis and portal hypertension. METHODS:Portal and hepatic arterial Doppler ultrasound was performed on 76 patients with cirrhosis and esophageal varices and on 73 age- and sex-matched controls. The parameters evaluated were portal venous velocity and hepatic arterial pulsatility index. The liver vascular index was calculated as the ratio of portal venous velocity to hepatic arterial pulsatility index. RESULTS:Portal venous velocity was significantly lower (11.0 +/- 2.4 vs 15.9 +/- 2.8 cm/s, p < 0.001) and hepatic arterial pulsatility index was significantly higher (1.28 +/- 0.18 vs 0.95 +/- 0.17,p < 0.001) in patients than in controls. Thus, the liver vascular index was significantly lower in patients than in controls (8.7 +/- 2.1 vs 17.2 +/- 4.3 cm/s, p < 0.001). The sensitivity and specificity of these parameters in the detection of cirrhosis and portal hypertension was then analyzed with the receiver operating characteristic curve. The best cut-off values were considered to be 13 cm/se of portal venous velocity and 1.1 of hepatic arterial pulsatility index, showing a sensitivity and specificity of 83, 85, 84, and 81%, respectively. The best cut-off value of the liver vascular index was 12 cm/s with a sensitivity and specificity of 97 and 93%, respectively. CONCLUSIONS:The liver vascular index is a high sensitive and specific Doppler ultrasound parameter in the diagnosis of cirrhosis and portal hypertension.

背景与目标： 目的：本前瞻性研究旨在评估多普勒超声参数在肝硬化和门静脉高压症诊断中的敏感性和特异性。
方法：对76例肝硬化和食管静脉曲张患者以及73例年龄和性别匹配的对照者进行门静脉和肝动脉多普勒超声检查。评价的参数是门静脉速度和肝动脉搏动指数。肝血管指数计算为门静脉速度与肝动脉搏动指数之比。
结果：门静脉血流速度显着降低（11.0 /-2.4 vs 15.9 /-2.8 cm / s，p <0.001），肝动脉搏动指数显着升高（1.28 /-0.18 vs 0.95 /-0.17，p <0.001）患者比对照组。因此，患者的肝血管指数显着低于对照组（8.7 /-2.1对17.2 /-4.3 cm / s，p <0.001）。然后使用接收器工作特性曲线分析这些参数在检测肝硬化和门脉高压中的敏感性和特异性。最佳临界值被认为是门静脉速度的13 cm / se和肝动脉搏动指数的1.1，分别显示出83％，85％，84％和81％的敏感性和特异性。肝血管指数的最佳临界值为12 cm / s，敏感性和特异性分别为97％和93％。
结论：肝血管指数是诊断肝硬化和门静脉高压症的高敏感度和特异性多普勒超声参数。

BACKGROUND & AIMS: :Systemic lupus erythematosus (SLE) is an autoimmune disease that usually develops in young women aged 18-50 years and is characterized by the presence of autoantibodies. Diagnosis is difficult as SLE is a great imitator of other diseases. When SLE is suspected clinically in a patient (involvement of two or more organ systems), an initial laboratory evaluation would be antinuclear antibody (ANA) testing. If ANA is negative, SLE is unlikely and results positive at less than 1:40 strongly argue against SLE. Other explanations for organ system involvement should be pursued. Results positive at greater than 1:40 may merit further evaluation for SLE and at times referral to a rheumatologist for a full SLE evaluation. While the American College of Rheumatology classification criteria for SLE are primarily a tool for research, they may be useful clinically, in that those patients fulfilling four or more criteria are highly likely to have SLE.

背景与目标： 系统性红斑狼疮（SLE）是一种自身免疫性疾病，通常在18至50岁的年轻女性中发展，其特征是存在自身抗体。由于SLE是其他疾病的重要模仿者，因此诊断很困难。当临床上怀疑患者患有SLE（涉及两个或多个器官系统）时，最初的实验室评估应为抗核抗体（ANA）测试。如果ANA阴性，则SLE可能性不大，结果小于1:40的阳性结果强烈反对SLE。应寻求器官系统参与的其他解释。大于1:40的阳性结果可能需要进一步评估SLE，有时还需要风湿病专家进行完整的SLE评估。尽管美国风湿病学会针对SLE的分类标准主要是研究工具，但它们可能在临床上有用，因为那些符合四个或更多标准的患者极有可能患有SLE。

BACKGROUND & AIMS: :Invasive diagnostic and therapeutic techniques are indispensable for the diagnosis and interventional treatment of coronary artery disease, valvular involvement and, in particular, if the specific components of the inflammatory or degenerative processes in rheumatic disease are to be identified in the different components of the heart. Although impairment of cardiac function and ischaemia can be suspected also by non-invasive techniques, coronary involvement needs the final proof by angiography. Endomyocardial or epicardial biopsy identifies the key players of autoreactivity: the infiltrating cells and the bound and circulating antibodies. Before corticoid treatment is started, a viral or microbial aetiology has to be excluded at the site of cardiac inflammation. This again can only be done by the analysis of cardiac tissue samples.

背景与目标： ：侵入性诊断和治疗技术对于冠状动脉疾病，瓣膜受累的诊断和介入治疗是必不可少的，特别是如果要在心脏的不同部分确定风湿性疾病中炎症或退行性过程的特定组成部分。尽管也可以通过非侵入性技术怀疑心脏功能和局部缺血的损害，但冠状动脉受累需要通过血管造影最终证明。心内膜或心外膜活检确定了自身反应的关键因素：浸润细胞以及结合和循环的抗体。在开始皮质激素治疗之前，必须在心脏炎症部位排除病毒或微生物病因。同样，这只能通过对心脏组织样本进行分析来完成。

BACKGROUND & AIMS: RATIONALE AND OBJECTIVES:Our purpose in this study was to investigate the usefulness of follow-up magnification mammograms (i.e., both current and previous magnification mammograms) in a computer-aided diagnosis (CAD) scheme for identifying the histological classification of clustered microcalcifications. MATERIALS AND METHODS:Our database consisted of current and previous magnification mammograms obtained from 93 patients before and after 3-month follow-up: 11 invasive carcinomas, 19 noninvasive carcinomas of the comedo type, 25 noninvasive carcinomas of the noncomedo type, 23 mastopathies, and 15 fibroadenomas. In our CAD scheme, we extracted five objective features of clustered microcalcifications from each of the current and previous magnification mammograms by taking into account image features that experienced radiologists commonly use to identify histological classifications. These features were then merged by a modified Bayes discriminant function for distinguishing among five histological classifications. For the input of the modified Bayes discriminant function, we used five objective features obtained from the previous magnification mammogram (previous features), five objective features obtained from the current magnification mammogram (current features), and the set of the five previous features and the five current features. RESULTS:The classification accuracies with the five current features were higher than those with the five previous features. These classification accuracies were improved substantially by using the set of the five previous features and the five current features. For the set of the five previous features and the five current features, the classification accuracies of our CAD scheme were 81.8% (9 of 11) for invasive carcinoma, 84.2% (16 of 19) for noninvasive carcinoma of the comedo type, 76.0% (19 of 25) for noninvasive carcinoma of the noncomedo type, 73.9% (17 of 23) for mastopathy, and 86.8% (13 of 15) for fibroadenoma. CONCLUSION:Our CAD scheme with use of follow-up magnification mammograms improved classification performance for mammographic clustered microcalcifications.

背景与目标： 理由和目的：我们在这项研究中的目的是研究在计算机辅助诊断（CAD）方案中对后续放大的乳房X线照片（即当前和以前的放大X线照片）的有效性，以识别簇状微钙化的组织学分类。
材料和方法：我们的数据库包含从3个月的随访前后的93例患者获得的当前和以前的放大乳房X线照片：11个浸润性癌，19个粉刺型非浸润性癌，25个非粉刺型非浸润性癌，23个乳腺病，和15个纤维腺瘤。在我们的CAD方案中，我们通过考虑经验丰富的放射科医生通常用来识别组织学分类的图像特征，从当前和以前的放大倍数乳房X线照片中提取出簇状微钙化的五个客观特征。然后，通过改进的贝叶斯判别函数合并这些特征，以在五种组织学分类之间进行区分。对于修改的贝叶斯判别函数的输入，我们使用了从先前的放大倍数X线照片（先前的特征）获得的五个客观特征，从当前的放大倍数X线图（当前特征）获得的五个客观特征，以及五个先前的特征和当前的五个功能。
结果：具有五个当前特征的分类准确度高于具有五个先前特征的分类准确度。通过使用五个先前功能和五个当前功能的集合，大大提高了这些分类的准确性。对于这五个先前特征和五个当前特征的集合，我们的CAD方案的分类准确度对于浸润性癌为81.8％（11个中的9个），粉刺型非浸润性癌为84.2％（19个中的16个），76.0％对于非粉刺型非侵袭性癌，其诊断率为（25分之19），对于乳腺病为73.9％（23分之17），对于纤维腺瘤则为86.8％（15分之13）。
结论：我们的CAD方案采用了后续放大的乳腺X线照片，改善了乳腺X线照相群集微钙化的分类性能。

BACKGROUND & AIMS: Evidence of a significant metabolic acidosis, an umbilical artery base deficit > 12 mmol/L, confirms that an asphyxial exposure has occurred. This is observed at delivery in approximately 2% of all pregnancies. Classification of the severity of the asphyxial exposure is difficult because the duration and nature of the exposure and the characteristics of the fetal cardiovascular response to the asphyxia in the affected fetus is usually not known. A classification is proposed in which the exposure to asphyxia is confirmed by a blood gas and acid-base assessment with evidence of a significant metabolic acidosis and the severity is defined by newborn encephalopathy and other organ system complications. Outstanding issues that may enhance this classification are identified.

背景与目标： 明显的代谢性酸中毒，脐动脉基础缺损> 12 mmol / L的证据证实发生了窒息。大约有2％的孕妇在分娩时观察到这种情况。窒息暴露严重程度的分类很困难，因为通常不知道暴露的持续时间和性质以及胎儿对窒息对窒息的心血管反应特征。提出了一种分类，其中通过血气和酸碱评估证实窒息暴露，并伴有明显的代谢性酸中毒，严重程度则由新生儿脑病和其他器官系统并发症定义。确定了可能会增强此分类的突出问题。

BACKGROUND & AIMS: :The Authors report their personal experience relating to diagnostic screening for prostatic carcinoma using serum assays for specific markers of this tumour: prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA). They underline the importance of high serum values of these substances, especially in tumors in an advanced state, and point out that these markers can play a role both in the diagnosis and in the follow-up of prostatic carcinoma.

背景与目标： ：作者报告了他们的个人经验，涉及使用血清检测该肿瘤的特定标志物（前列腺酸磷酸酶（PAP）和前列腺特异抗原（PSA））进行前列腺癌的诊断筛查。他们强调了这些物质的高血清值的重要性，尤其是在晚期肿瘤中，并指出这些标志物可以在前列腺癌的诊断和随访中发挥作用。

BACKGROUND & AIMS: :Inborn errors of vitamin B(12) (cobalamin) metabolism are characterized by decreased production of active cobalamin cofactors and subsequent deficiencies in the activities of methionine synthase and methylmalonyl-CoA mutase. With the recent discovery of the cblJ defect in two patients with phenotypes mimicking the cblF defect, there are nine genes known to be involved in cobalamin metabolism. The new defect is caused by mutations in the ABCD4 gene, encoding an ABC transporter. At the moment, there is no clear distinction between the cblJ and cblF defects either clinically or biochemically, and both defects result in blocks in the transport of cobalamin from the lysosome to the cytoplasm. A patient was diagnosed with hyperhomocysteinemia and methylmalonic aciduria at the age of 8 years. Incorporations of both [(14)C]propionate and [(14)C]methyltetrahydrofolate in cultured fibroblasts were within reference ranges and thus too high to allow for complementation analysis. We observed decreased synthesis of both adenosylcobalamin and methylcobalamin and accumulation of unmetabolized cyanocobalamin. Exome sequencing was performed to identify causative mutation(s) and Sanger re-sequencing was performed to validate segregation of mutation in the family. By this approach, a homozygous mutation, c.423C>G, in the ABCD4 gene was identified. Here, we report the successful application of exome sequencing for diagnosis of a rare inborn error of vitamin B(12) metabolism in a patient whose unusual presentation precluded diagnosis using standard biochemical and genetic approaches. The patient represents only the third known patient with the cblJ disorder.

背景与目标： ：维生素B（12）（钴胺素）代谢的先天性错误的特征在于活性钴胺素辅因子的产生减少以及蛋氨酸合酶和甲基丙二酰辅酶A突变酶的活性随后不足。随着最近在两名模仿cblF缺陷的表型患者中发现cblJ缺陷，已知有9个基因与钴胺素代谢有关。新的缺陷是由编码ABC转运蛋白的ABCD4基因突变引起的。目前，在临床或生化方面，cblJ和cblF缺陷之间尚无明确区分，并且两种缺陷均导致钴胺素从溶酶体到细胞质的转运受阻。一名患者在8岁时被诊断出患有高同型半胱氨酸血症和甲基丙二酸尿症。 [（14）C]丙酸酯和[（14）C]甲基四氢叶酸在培养的成纤维细胞中的掺入均在参考范围内，因此含量过高，无法进行互补分析。我们观察到腺苷钴胺素和甲基钴胺素的合成减少以及未代谢的氰钴胺素的积累。进行了外显子组测序以鉴定致病突变，并进行了桑格重测序以验证家族中突变的分离。通过这种方法，鉴定出ABCD4基因中的纯合突变，即c.423C> G。在这里，我们报告外显子组测序在维生素B（12）代谢的罕见先天性错误的诊断中成功应用，该患者的异常表现排除了使用标准生化和遗传方法进行诊断的可能性。该患者仅代表第三位已知的cblJ疾病患者。

BACKGROUND & AIMS: :Individuals at 50% risk of Huntington's disease (HD) who prefer not to know their carrier status, might opt for exclusion prenatal diagnosis (ePND) or exclusion preimplantation genetic diagnosis (ePGD). This study aims to provide a better understanding of couples' motives for choosing ePND or ePND, and surveys couples' experiences in order to make recommendations for the improvement of counselling for exclusion testing. This qualitative retrospective interview study focussed on couples who underwent ePND or ePGD for HD in the period 1996-2010. Seventeen couples were included of which 13 had experienced ePND and 6 ePGD. Mean time-interval since exclusion-testing was 3.9 years. Couples' moral reservations regarding termination of pregnancy (TOP) or discarding healthy embryos were counterbalanced by the wish to protect their future child against HD. Seven couples had terminated a total of 11 pregnancies with a 50% HD risk, none showed regret. ePGD was used by couples who wanted to avoid (another) TOP. ePND and ePGD are acceptable reproductive options for a specific group of counsellees. To guarantee sound standards of care, it is imperative that candidate couples be given in-depth non-directive counselling about all possible scenarios, and adequate professional and psychological support prior to, during and after ePND/ePGD.

背景与目标： ：那些不知道自己的携带者状况，患亨廷顿氏病（HD）风险为50％的个体，可能会选择排除产前诊断（ePND）或排除植入前遗传学诊断（ePGD）。这项研究旨在更好地了解夫妻选择ePND或ePND的动机，并调查夫妻的经历，以便为改善排除测试的咨询意见提供建议。这项定性的回顾性访谈研究的重点是在1996-2010年期间接受HD的ePND或ePGD的夫妇。其中包括17对夫妇，其中13对有ePND经历和6对ePGD。自排除测试以来的平均时间间隔为3.9年。保护夫妻免于高清的愿望抵消了夫妻在终止妊娠（TOP）或丢弃健康胚胎方面的道德保留。 7对夫妇共终止了11例妊娠，HD风险为50％，没有人表示遗憾。希望避免使用（另一种）TOP的夫妇使用了ePGD。 ePND和ePGD是特定人群的可接受的生殖选择。为了保证合理的护理标准，在ePND / ePGD之前，之中和之后，必须为候选夫妇提供有关所有可能情况的深入非指导性咨询，并提供适当的专业和心理支持。

BACKGROUND & AIMS: BACKGROUND:To investigate the relationship between the levels of serum complement C1q and the risk and severity of acute ischemic stroke, a total of 154 patients with acute ischemic stroke and 42 healthy volunteers as normal controls were enrolled in the present study. METHODS:According to the onset time of stroke, patients were divided into three groups. Using an immune transmission turbidity method, the levels of serum complement C1q were detected to investigate the relationship between the level of serum complement C1q and the incidence and severity of acute ischemic stroke. The risk factors of these groups were calculated using a conditional logistic regression model. The assessment of neurological function impairment was carried out according to the National Institute of Health Stroke Scale. Then correlation anal- ysis was carried out between the level of serum complement C1q among patients with acute ischemic stroke and the degree of neurological function impairment. RESULTS:The results showed that the level of serum complement C1q was higher in the ischemic stroke group than in the control group. Using a conditional logistic regression model it was discovered that serum complement C1q was the independent pathogenic factor of cerebral infarction. There also was a decreasing trend in the level of serum complement C1q with the extension of the onset time and an increasing trend in the level of serum complement C1q with the increase in the maximum diameter of infarction volume. CONCLUSIONS:Serum complement C1q is an independent risk factor for acute outbreak of ischemic stroke, whose level is closely related to the outbreak and infarct size and neurological function impairment.

背景与目标： 背景：为了研究血清补体C1q水平与急性缺血性中风的风险和严重程度之间的关系，本研究共纳入154例急性缺血性中风患者和42名健康志愿者作为正常对照。
方法：根据中风的发作时间，将患者分为三组。采用免疫传递浊度法检测血清补体C1q水平，以探讨血清补体C1q水平与急性缺血性脑卒中的发生率和严重程度之间的关系。使用条件逻辑回归模型计算这些组的危险因素。根据美国国立卫生研究院卒中量表对神经功能损害进行评估。然后在急性缺血性中风患者的血清补体C1q水平与神经功能损害程度之间进行相关分析。
结果：缺血性中风组血清补体C1q水平高于对照组。使用条件逻辑回归模型，发现血清补体C1q是脑梗死的独立致病因素。随着发作时间的延长，血清补体C1q的水平也有降低的趋势，并且随着梗塞体积的最大直径的增加，血清补体C1q的水平也有增加的趋势。
结论：血清补体C1q是缺血性卒中急性发作的独立危险因素，其水平与发作，梗死面积和神经功能损害密切相关。

BACKGROUND & AIMS: :Hereditary cancer due to pathological mutations in the mismatch repair gene family is now known as Lynch syndrome and affects at least 1 in 1,000 people, resulting in a 30-50% cancer risk most often involving the colorectum and endometrium. Annual or biennial colonoscopy reduces cancer deaths and many offer gynaecological surveillance, but most other associated cancers are not amenable to early detection. As microsatellite instability testing and tumour immunohistochemistry become routine, case finding will improve. Our recent demonstration that 600 mg aspirin per day for at least 2 years reduces the cancer burden by 63% after a 3-year lag period reinforces the need to identify gene carriers and introduce them to chemoprevention. CaPP3 will test different doses of aspirin in at least 3,000 gene carriers to determine whether low-dose aspirin is as effective.

背景与目标： ：由于失配修复基因家族中的病理突变而引起的遗传性癌症现在被称为Lynch综合征，它影响至少1,000人中的1个人，导致30-50％的癌症风险最常涉及结直肠癌和子宫内膜癌。一年一次或每两年一次的结肠镜检查可以减少癌症死亡，并且许多可以提供妇科检查，但是大多数其他相关的癌症不适合早期发现。随着微卫星不稳定性测试和肿瘤免疫组织化学成为常规方法，病例发现将得到改善。我们最近的研究表明，在3年的滞后期后，每天至少2年每天服用600毫克阿司匹林可将癌症负担降低63％，这增强了识别基因载体并将其引入化学预防的需求。 CaPP3将在至少3,000个基因携带者中测试不同剂量的阿司匹林，以确定低剂量阿司匹林是否有效。

BACKGROUND & AIMS: :Cyst infection is a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD) because of the lack of specific manifestations and limitations of conventional imaging procedures. Still, recent clinical observations and series have highlighted common criteria for this condition. Cyst infection is diagnosed if confirmed by cyst fluid analysis showing bacteria and neutrophils, and as a probable diagnosis if all four of the following criteria are concomitantly met: temperature of >38°C for >3 days, loin or liver tenderness, C-reactive protein plasma level of >5 mg/dL and no evidence for intracystic bleeding on computed tomography (CT). In addition, the elevation of serum carbohydrate antigen 19-9 (CA19-9) has been proposed as a biomarker for hepatic cyst infection. Positron-emission tomography after intravenous injection of 18-fluorodeoxyglucose, combined with CT, proved superior to radiological imaging techniques for the identification and localization of kidney and liver pyocyst. This review summarizes the attributes and limitations of these recent clinical, biological and imaging advances in the diagnosis of cyst infection in patients with ADPKD.

背景与目标： ：由于常染色体显性多囊肾病（ADPKD）患者缺乏特异​​性表现和常规影像学检查的局限性，因此对囊性感染的诊断是一项挑战。尽管如此，最近的临床观察和系列研究突显了这种情况的共同标准。如果囊肿液分析证实存在细菌和中性粒细胞，则可以诊断为囊肿感染，并且如果同时满足以下四个标准，则可能诊断为囊肿：温度> 38°C持续3天以上，腰部或肝脏压痛，C反应血浆血浆蛋白水平> 5 mg / dL，计算机断层扫描（CT）尚无囊内出血的证据。另外，已经提出血清碳水化合物抗原19-9（CA19-9）的升高作为肝囊肿感染的生物标志物。静脉注射18-氟脱氧葡萄糖后结合CT进行正电子发射断层扫描，事实证明其优于放射成像技术可用于肾脏和肝囊肿的鉴定和定位。这篇综述总结了ADPKD患者囊肿感染诊断中这些最新的临床，生物学和影像学进展的属性和局限性。

BACKGROUND & AIMS: :Early diagnosis of breast cancer is essential to save lives of patients. Usually, medical datasets include a large variety of data that can lead to confusion during diagnosis. The Knowledge Discovery on Database (KDD) process helps to improve efficiency. It requires elimination of inappropriate and repeated data from the dataset before final diagnosis. This can be done using any of the feature selection algorithms available in data mining. Feature selection is considered as a vital step to increase the classification accuracy. This paper proposes a Modified Bat Algorithm (MBA) for feature selection to eliminate irrelevant features from an original dataset. The Bat algorithm was modified using simple random sampling to select the random instances from the dataset. Ranking was with the global best features to recognize the predominant features available in the dataset. The selected features are used to train a Random Forest (RF) classification algorithm. The MBA feature selection algorithm enhanced the classification accuracy of RF in identifying the occurrence of breast cancer. The Wisconsin Diagnosis Breast Cancer Dataset (WDBC) was used for estimating the performance analysis of the proposed MBA feature selection algorithm. The proposed algorithm achieved better performance in terms of Kappa statistic, Mathew’s Correlation Coefficient, Precision, F-measure, Recall, Mean Absolute Error (MAE), Root Mean Square Error (RMSE), Relative Absolute Error (RAE) and Root Relative Squared Error (RRSE).

背景与目标： ：早期诊断乳腺癌对于挽救患者生命至关重要。通常，医学数据集包括各种各样
可能导致诊断过程中混乱的数据。数据库知识发现（KDD）流程有助于
提高效率。在最终诊断之前，需要从数据集中消除不适当和重复的数据。
这可以使用数据挖掘中可用的任何特征选择算法来完成。考虑功能选择
作为提高分类准确性的重要步骤。本文针对特征提出了一种改进的Bat算法（MBA）
选择以从原始数据集中消除不相关的特征。使用简单随机算法修改了Bat算法
采样以从数据集中选择随机实例。排名具有全球最佳功能，可识别
数据集中可用的主要特征。所选要素用于训练随机森林（RF）分类
算法。 MBA特征选择算法提高了RF在识别事件中的分类精度
乳腺癌。威斯康星州诊断乳腺癌数据集（WDBC）用于评估性能
提出的MBA特征选择算法的分析。提出的算法取得了较好的性能。
Kappa统计数据，Mathew的相关系数，精度，F度量，召回率，平均绝对误差（MAE），
均方根误差（RMSE），相对绝对误差（RAE）和均方根误差（RRSE）。